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| 苏州大学附属儿童医院碳青霉烯类耐药肠杆菌目细菌流行特征及耐药基因分析 |
| Epidemiology of Carbapenem-resistant Enterobacteriaceae in the city of Soochow |
| 投稿时间：2021-07-23 |
| DOI：10.3969/j.issn.1000-0399.2022.03.005 |
| 中文关键词: 碳青霉烯类耐药的肠杆菌 儿童 苏州 |
| 英文关键词: CRE Children Soochow |
| 基金项目:国家自然科学基金青年基金(项目编号:81602074) |
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| 中文摘要: |
| 目的 了解苏州大学附属儿童医院碳青霉烯类耐药的肠杆菌目细菌(CRE)的临床分布及耐药性特点,为院内感染控制及临床合理使用抗生素提供理论依据。方法 统计分析2018～2020年苏州大学附属儿童医院感染性标本中分离得到的CRE临床分布特点及耐药性。聚合酶链式反应法分析碳青霉烯酶基因(blaNDM、blaKPC、blaIMP、blaVIM及blaOXA-48)。结果 近3年CRE检出率为9.59%,以大肠埃希菌(CR-ECO)[100株(54.94%)]及肺炎克雷伯菌(CR-KPN)[71株(39.01%)]为主,主要分离于尿液及痰液。CRE对氨基糖苷类以外的多种抗生素耐药率均高于80%。患者主要为≤1岁的儿童。58.27%的CRE检出碳青霉烯酶基因,以NDM[42株(59.15%)]型为主,VIM型[28株(39.43%)]次之。NDM以NDM-5型[25株(59.52%)]为主,NDM-2型[15株(35.71%)]次之。CR-ECO以blaNDM[20株(80.00%)]为主,blaKPC[6株(24.00%)]次之,而CR-KPN以blaVIM [26株(55.32%)]为主,blaNDM[21株(44.68%)]次之。并在多株CRE中同时检测到多个碳青霉烯酶。结论 苏州大学附属儿童医院CRE分离率较高,尤其是大肠埃希菌,需要加强医院感染防控措施,合理使用各种抗菌药物。 |
| 英文摘要: |
| Objective To investigate the dissemination and clinical information of Carbapenem-resistant Enterobacteriaceae (CRE) isolated from the Children’s Hospital of Soochow University. Methods In 2018~2020 specimens of infected patients in the Children’s Hospital of Soochow University were performed with pathogenic culture andidentification. The CRE were screened based on the drug sensitivity results. The main carbapenemase genes(blaNDM, blaKPC, blaIMP, blaVIM and blaOXA-48) were tested by PCR. Results In 2018-2020a total of 182 CRE were determined in thehospital, andthe isolated rate was 9.59%. The top two bacterial species were Escherichia coli (100 strains) and Klebsiella pneumoniae(71 strains). Urinary tract infections were the most common, followed by pneumonia. Age distribution indicated that most of patients were young children who were≤1 year old. More than 80% of the CRE isolates were resistant to different classes of antibiotics such as cephalosporins, carbapenems, quinolones, sulfonamides, except aminoglycosides.Carbapenem resistance genes were identified in 58.3% CRE. The most prevalence carbapenemases genes wereblaNDM [42 strains (59.2%)], followed by blaVIM [28 strains (39.4%)]. The top two type of blaNDM were blaNDM-5 [25 strains (59.5%)] and blaNDM-2 [15strains (35.7%)]. blaNDM [42 strains (59.2%)]was the most prevalent carbapenemase gene detected in CR-ECO followed by blaKPC [6 strains (24%)], while blaVIM [26 strains (55.32%)] was prevalent in CR-KPN followed by blaNDM ([21 strains (44.68%)]. Some isolates coproduced two or three carbapenemases were also detected in this study. Conclusions The detection rate of CRE especially of Escherichia coli in the hospitalis high. The monitoring and prevention of CRE should be strengthened and antibacterial drugs should be used rationally. |
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