Antimicrobial resistance of Enterobacteriacea and distribution characteris-tics of carbapenemase-resistant strains / 中国感染控制杂志

ABSTRACT

Objective To understand antimicrobial resistance of Enterobacteriaceae strains and distribution charac-teristics of carbapenemase-resistant Enterobacteriaceae(CRE)in Xijing Hospital in 2015,so as to provide basis for rational use of antimicrobial agents in clinic. Methods Specimens from infected inpatients and outpatients in Xijing Hospital in January-December 2015 were performed pathogenic culture,isolation and identification. Antimicrobial susceptibility testing was performed with Kirby-Bauer method,carbapenemase confirmatory test was conducted with modified Hodge test,antimicrobial resistance of Enterobacteriaceae was statistically analyzed. Results A total of 4166 pathogenic strains were isolated in 2015,1554 (37.30% )of which were Enterobacteriaceae strains,the top 5 isolated pathogens were Escherichiacoli(E. coli),Klebsiella pneumoniae(K. pneumoniae),Enterobactercloacae (E. cloacae),Proteusmirabilis,and Enterobacteraerogenes. Of 787 E. coli strains,581(73.82% )were extend-ed-spectrumβ-lactamases(ESBLs)-producing strains;of 367 K. pneumoniae strains,182 (49.59% )were ESBLs-producing strains. E. coli and K. pneumoniae had the highest resistance rates to cefazolin,which were 93.14% and 78.48% respectively. A total of 81 (5.21% )CRE were detected,K. pneumoniae,E. cloacae,and E. coli were 41 ,27,and 13 strains respectively;strains were mainly isolated from patients in departments of neurosurgery(n=42),gastroenterology(n= 9),and neurology(n= 8). 1.02% (8/787)of E. coli and 3.27% (12/367)of K. pneu-moniae were multidrug-resistant. Conclusion Enterobacteriaceae accounted for a higher proportion of pathogenic bacteria causing HAI,the detection rate of ESBLs-producing strains remains high,the isolation rate of carbapenem-resistant Enterobacteriaceae is higher than that of last year,especially K. pneumoniae.