关键词:

碳青霉烯类耐药革兰阴性杆菌, 分布特点, 耐药性

Abstract:

Objective　To analyze the distribution and drug resistance characteristics of Carbapenem resistant Gram-negative bacilli (CR-GNB) isolated from Guangdong Provincial Second Hospital of Traditional Chinese Medicine. Methods　From January 1, 2021 to June 30, 2023, 2 754 strains of CR-GNB were identified by clinical isolation and identification in Guangdong Provincial Second Hospital of Traditional Chinese Medicine. The WHONET5.6 software was used to analyze the distribution characteristics of CR-GNB and the characteristics of drug susceptibility detection resistance. Results　A total of 2 754 strains of CR-GNB were clinically isolated and screened, including 843 strains of carbapenem-resistant Klebsiella pneumoniae (CRKP), accounting for 30.6%, 765 strains of Carbapenem-resistant Acinetobacter baumannii (CRAB), accounting for 27.8%, 679 strains of Carbapenem-resistant Pseudomonas aeruginosa (CRPA), accounting for 24.7%, 203 strains of carbapenem-resistant Escherichia coli (CREC), accounting for 7.4%, and 264 strains of other CR-GNB, accounting for 9.5%. The main sources of CR-GNB samples were sputum (1 702 strains, 61.8%), urine (639 strains, 23.2%), alveolar lavage fluid (232 strains, 8.4%), blood (78 strains, 2.8%), and secretions (71 strains, 2.6%). The main departments were respiratory and critical care medicine (532 strains, 19.3%), intensive care medicine (365 strains, 13.3%), Acupuncture Kang District 1 (325 strains, 11.8%), and Acupuncture Kang District 7 (181 strains, 6.6%). A total of 1 330 strains (48.9%) were isolated from the Acupuncture Kang Districts. CR-GNB generally has multiple drug resistance or pan-resistance to antibiotics, and the sensitivity rate of a few drugs is high. The sensitivity rate of CRKP to tigacycline was 100.0%. The sensitivity rates of CRAB to amikacin, tobramycin, and minocycline were 73.9%, 59.0%, and 49.3%, respectively. The sensitivity rates of CRPA to amikacin, tobramycin, and polymyxin B were 78.1%, 75.5%, and 46.5%, respectively. The sensitivity rate of CREC to tigecycline was 100.0%. Conclusions　The CR-GNB isolated in Guangdong Provincial Second Hospital of Traditional Chinese Medicine are mainly CRKP, CRAB, CRPA, and CREC. CR-GNB is multi-drug resistant or pan-resistant, and the available therapeutic drugs are limited. Clinical use of antibiotics should be regulated, and effective and feasible treatment plans should be formulated according to the drug resistant characteristics of CR-GNB to prevent nosocomial infection and spread of CR-GNB.

Key words:

Carbapenem resistant Gram-negative bacilli, Distribution characteristics, Drug resistance