关键词: 碳青霉烯类耐药肠杆菌科细菌, 耐药性, 住院患者

Abstract:

Objective To analyze the incidence and resistantspectrum of carbapenem-resistant Enterobacteriaceae（CRE）in Yueyang Hospital of Integrated Traditional Chinese and Western Medicine form 2015 to 2019. Methods A total of 5 980 strains of Enterobacteriaceae were collected from various clinical specimens of inpatients from 2015 to 2019. VITEK 2 Compact 60 automatic bacterial identification system was used to identify the bacteria. Antimicrobial susceptibility testing was carried out using Kirby-Bauer method or automated system. Results A total of 923 strains（15.4%）of CRE were isolated,and the incidence of CRE showed a significant upward trend.The mean age of patients with CRE infection was（76.9±14.5）years old,and patients aged ≥60 years old accounted for 89.8%. CRE was isolated mainly from respiratory tract specimens （558 strains,60.5%）,and distributed in 30 clinical departments. In these departments, the geriatrics department had the highest detection rate （21.5%）,followed by 20.9% in the intensive care unit. Among 923 CRE isolates,carbapenem-resistant Klebsiella pneumonia was the most prevalence species（77.7%）,followed by carbapenem-resistant Escherichia coli（10.9%）. Drug sensitivity test results showed that the resistance rates of CRE to the commonly used antibiotics were above 80.0%,and the resistance rates to tigecycline,polymyxin B,amikacin,trimethoprim/sulfamethoxazole,tobramycin and gentamicin were relatively low（4.1%,5.9%,51.7%,58.4%,66.5% and 75.0%）Conclusion The CRE incidence rate of inpatients in Yueyang Hospital is on the rise from 2015 to 2019. CRE were mainlyisolatedfrom elderly patientsaged ≥ 60 years old. CRE strains involve a wide range of clinical departmentand show high resistance to most commonly used antimicrobials. Hospitals should strengthen the prevention and control of CRE infection and intelligent use of antibiotics.

Key words: Carbapenem-resistant Enterobacteriaceae, Drug resistance, Inpatients