Analysis of drug resistance of rare CRE and clinical application of carbapenem screening test in Henan

doi:10.3969/j.issn.1673-8640.2022.02.010

Abstract

Abstract:

Objective To investigate the determination and drug resistance characteristics of rare carbapenem-resistant Enterobacteriaceae（CRE）in Henan No.3 Provincial People's Hospital,to investigate the clinical application of CRE enzyme screening test,and to provide a reference for rational clinical use of antibiotics. Methods The non-repetitive rare CRE isolated in 2019 were collected,and the results of drug resistance sensitivity test in vitro were collected. There were 22 isolates randomly collected,and the carbapenem-producing enzyme patterns of 22 isolates were determined by ethylenediaminetetraacetic acid（EDTA）,3-aminophenylboric acid（APBA） carbapenemase inhibition test and colloidal gold immunochromatography. Results A total of 1 111 isolates of CRE were determined in 2019,which included 49 isolates of Enterobacter cloacae（15.4%）,14 isolates of Klebsiella acidogenes（19.2%） and 12 isolates of Citrobacter（13.8%）. The drug resistance rate of imipenem was 100%. Enterobacter,Klebsiella acidogenes and Citrobacter were sensitive to tigecycline and polymyxin B. The drug resistance rates of Proteus and Providencia which were naturally resistant to polymyxin B and tigecycline were 5.3% and 14.3%,respectively. Totally,13 isolates of NDM type metalloenzyme,3 isolates of KPC type serinase,1 isolate of OXA type serinase,1 isolate of KPC+IMP+NDM type and 1 isolate of KPC+NDM type were determined in the 22 isolates of CRE. Conclusions The situation of drug resistance of CRE in Henan is serious,and it should be monitored in time and used antibiotics reasonably according to the results of drug resistance sensitivity test. The carbapenem screening test should be optimized to provide a reference for the accurate use of drugs in CRE.

Key words: Carbapenem-resistant Enterobacteriaceae, Drug resistance, Carbapenemase inhibition test, Colloidal gold immunochromatography

CLC Number:

Q554

SUN Ying, LI Yi, YAN Wenjuan, JING Nan, MA Bing. Analysis of drug resistance of rare CRE and clinical application of carbapenem screening test in Henan[J]. Laboratory Medicine, 2022, 37(2): 146-149.

Figures/Tables 3

References 10

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细菌名称	检出株数	构成比/%	菌株总数	检出率/%
肺炎克雷伯菌	939	84.6	1 814	51.8
大肠埃希菌	60	5.4	2 458	2.4
阴沟肠杆菌	49	4.4	319	15.4
产酸克雷伯菌	14	1.3	73	19.2
变形杆菌属	14	1.3	218	6.4
枸橼酸杆菌属	12	1.1	87	13.8
普罗威登斯菌属	9	0.8	30	30.0
摩根菌菌属	8	0.7	47	17.0
黏质沙雷菌	4	0.4	79	5.1

细菌名称	检出株数	构成比/%	菌株总数	检出率/%
肺炎克雷伯菌	939	84.6	1 814	51.8
大肠埃希菌	60	5.4	2 458	2.4
阴沟肠杆菌	49	4.4	319	15.4
产酸克雷伯菌	14	1.3	73	19.2
变形杆菌属	14	1.3	218	6.4
枸橼酸杆菌属	12	1.1	87	13.8
普罗威登斯菌属	9	0.8	30	30.0
摩根菌菌属	8	0.7	47	17.0
黏质沙雷菌	4	0.4	79	5.1

抗菌药物	阴沟肠杆菌（49株）	产酸克雷伯菌（14株）	变形杆菌属（14株）	枸橼酸杆菌属（12株）	普罗维登斯菌属（9株）
哌拉西林	91.8	100.0	50.0	100.0	50.0
阿莫西林-克拉维酸	100.0	100.0	45.0	100.0	100.0
头孢哌酮-舒巴坦	77.6	100.0	20.0	100.0	57.1
氨苄西林-舒巴坦	91.8	100.0	50.0	91.7	87.5
哌拉西林-他唑巴坦	89.8	100.0	15.0	100.0	37.5
头孢他啶	89.8	100.0	23.8	100.0	62.5
头孢噻肟	91.8	100.0	55.0	100.0	62.5
头孢吡肟	85.7	100.0	30.0	100.0	50.0
氨曲南	77.1	76.9	5.3	66.7	14.3
亚胺培南	100.0	100.0	100.0	100.0	100.0
美罗培南	81.6	100.0	15.0	100.0	37.5
阿米卡星	16.3	7.1	25.0	25.0	50.0
庆大霉素	49.0	42.9	60.0	58.3	75.0
环丙沙星	53.1	71.4	75.0	58.3	87.5
左氧氟沙星	51.0	50.0	70.0	58.3	75.0
复方磺胺甲噁唑	65.3	85.7	80.0	66.7	87.5
氯霉素	36.4	18.2	81.2	60.0	100.0
四环素	55.1	35.7	100.0	58.3	100.0
替加环素	0	0	天然耐药	0	天然耐药
多黏菌素B	0	0	天然耐药	0	天然耐药

抗菌药物	阴沟肠杆菌（49株）	产酸克雷伯菌（14株）	变形杆菌属（14株）	枸橼酸杆菌属（12株）	普罗维登斯菌属（9株）
哌拉西林	91.8	100.0	50.0	100.0	50.0
阿莫西林-克拉维酸	100.0	100.0	45.0	100.0	100.0
头孢哌酮-舒巴坦	77.6	100.0	20.0	100.0	57.1
氨苄西林-舒巴坦	91.8	100.0	50.0	91.7	87.5
哌拉西林-他唑巴坦	89.8	100.0	15.0	100.0	37.5
头孢他啶	89.8	100.0	23.8	100.0	62.5
头孢噻肟	91.8	100.0	55.0	100.0	62.5
头孢吡肟	85.7	100.0	30.0	100.0	50.0
氨曲南	77.1	76.9	5.3	66.7	14.3
亚胺培南	100.0	100.0	100.0	100.0	100.0
美罗培南	81.6	100.0	15.0	100.0	37.5
阿米卡星	16.3	7.1	25.0	25.0	50.0
庆大霉素	49.0	42.9	60.0	58.3	75.0
环丙沙星	53.1	71.4	75.0	58.3	87.5
左氧氟沙星	51.0	50.0	70.0	58.3	75.0
复方磺胺甲噁唑	65.3	85.7	80.0	66.7	87.5
氯霉素	36.4	18.2	81.2	60.0	100.0
四环素	55.1	35.7	100.0	58.3	100.0
替加环素	0	0	天然耐药	0	天然耐药
多黏菌素B	0	0	天然耐药	0	天然耐药

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