Abstract:

Objective To study the clinical infection and drug resistance of carbapenem-resistant Enterobacteriaceae（CRE） in Wuhan University Renmin Hospital,and to investigate the clinical application of ethylenediaminetetraacetic acid-modified carbapenem inactivation method（eCIM） combined with modified carbapenem inactivation method（mCIM） so as to effectively prevent and control infection and provide a reference for reasonable clinical use of antibiotics. Methods The drug susceptibility data of clinical isolates of non-repeatable CRE were analyzed. The mCIM and eCIM were combined to determine whether the 80 isolates produced metallo-beta-lactamase or serine carbapenemase [minimum inhibitory concentration（MIC）≥2 μg/mL]. Results A total of 329 CRE isolates were determined,and they are mainly Klebsiella pneumoniae,accounting for 59.0%. The departments were widely distributed,especially in intensive care unit（ICU） and neurosurgery,accounting for 16.4% and 16.1%,respectively. The infected sites were more common in the respiratory tract,accounting for 39.2%. The drug resistance rates of CRE isolates to the most antibiotics were more than 50.0%,except for minocycline and tigecycline,which were 25.1% and 2.9%,respectively. Totally,57 isolates of producing carbapenemase were determined among the randomly-chosen 80 CRE isolates,of which 28 isolates of metallo-beta-lactamase CRE were produced. Conclusions The drug resistance of CRE is severe in Wuhan University Renmin Hospital,which should be monitored at any time. It should use antibiotics based on drug susceptibility results rationally. The eCIM combined with mCIM is an economical and effective phenotypic detection method.

Key words: Carbapenem-resistant Enterobacteriaceae, Drug resistance, Metallo-beta-lactamase, Ethylenediaminetetraacetic acid-modified carbapenem inactivation method, Modified carbapenem inactivation method