Abstract：Objective To understand the changes of distribution characteristics and drug resistance characteristics of carbapenem resistant Enterobacteriaceae (CRE) in different intensive care units of our hospital during 2013—2018, providing theoretical basis for the prevention and treatment of CRE in key departments. Methods The drug sensitivity test was carried out with the methods of disc diffusion (KB), Phoenix-100 or VITEK 2 Compact automatic bacterial identification/drug sensitivity system. The data were analyzed with WHONET 5.6 and SPSS 22.0 statistical software. Results From 2013 to 2018, a total of 1,366 CRE strains were detected in different ICUs of our hospital, mainly Klebsiella pneumoniae (85.5%), which increased year by year. The detection rates of CRE in CICU and NICU were less than 10%. Meanwhile, the CRE detection rates in ICU, NSICU and RICU were up to 41.07%, 48.37% and 52.54%, respectively, which showed an increasing trend year by year. The lower respiratory tract specimen (58.93%) were the main sources of CRE, followed by blood(14.42%). There were statistical differences in composition ratio of CRE strains from lower respiratory tract and blood in different ICUs (P<0.0001). The proportion of CRE in the lower respiratory tract was highest in NSICU and CCU (78.53% and 75.81%, respectively). The ward with the highest proportion of CRE from blood was the PICU, accounting for 22.45%. Tigacycline resistance was not found in CRE, and polymyxomycin resistance was rare. The drug resistance rates to amikacin and compound sulfamethoxazole were 68.81% and 57.43% respectively, and the resistance rates to other drugs were more than 85%. Conclusion The overall detection rates of CRE showed an increasing trend, and the explosive growth was concentrated in 2014—2015, which was dominated by the growth of carbapene-resistant Klebsiella pneumoniae (CRKP). The detection rate of CRE in different ICUs was up to five times different, and the composition ratio of CRE in the lower respiratory tract and blood source was different. Specific measures should be taken to prevent and control infections in different ICUs.
荆楠 王山梅 闫文娟 许俊红 马琼 马冰 张江峰 楚亚菲 张琦 李轶. 2013—2018年某院不同ICU耐碳青霉烯肠杆菌的变迁[J]. 中国抗生素杂志, 2020, 45(08): 804-809.
Jing Nan, Wang Shan-mei, Yan Wen-juan, Xu Jun-hong, Ma Qiong, Ma Bing, Zhang Jiang-feng, . Changes of carbapenem resistant Enterobacteriaceae in different ICUs of a hospital from 2013 to 2018#br#. CJA, 2020, 45(08): 804-809.