2019-2023年甘肃省阴沟肠杆菌的分布及其耐药性

Distribution and drug resistance of Enterobacter cloacae in Gansu Province from 2019 to 2023

    摘要
  • 摘要:
    目的 分析2019-2023年甘肃省阴沟肠杆菌临床分布特点及耐药性, 为该地区阴沟肠杆菌感染防控提供参考。
    方法 收集甘肃省细菌耐药监测网成员单位2019-2023年各医院阴沟肠杆菌的分布及耐药监测数据, 使用药敏纸片扩散(K-B)法、最低抑菌浓度法和全自动化仪器法对阴沟肠杆菌进行体外药敏试验, 并分析药敏结果。
    结果 2019-2023年甘肃省共培养分离细菌402 490株, 其中阴沟肠杆菌17 417株, 检出率为4.33%;该菌主要分离自痰液标本, 其次为尿液和伤口脓液标本, 检出率分别为62.81%、7.37%和6.07%;科室分布以内科(44.96%)和外科(28.50%)为主; 患者年龄分布以成人组(15~65岁)最多, 检出率为45.79%;阴沟肠杆菌对20余种抗菌药物呈现不同程度的耐药性, 但总体耐药率呈下降趋势(P < 0.05), 其中对头孢唑林的耐药率最高(96.40%~98.38%), 对替加环素的耐药率最低(0.44%~2.92%)。耐碳青霉烯类阴沟肠杆菌的耐药率呈上升趋势, 亚胺培南的耐药率为2.79%~3.71%(P=0.044), 美罗培南的耐药率为1.29%~3.41%(P < 0.05)。
    结论 甘肃省阴沟肠杆菌的分离率保持稳定, 对多种抗菌药物的耐药性呈下降趋势, 但对碳青霉烯类抗菌药物的耐药性增加应引起重视。

     

    Abstract:
    OBJECTIVE To analyze the clinical distribution characteristics and drug resistance of Enterobacter cloacae in Gansu Province from 2019 to 2023, providing reference for the prevention and control of E.cloacae infections in this region.
    METHODS Data on the distribution and drug resistance of E.cloacae from hospitals in member units of the Gansu Antimicrobial Surveillance Network between 2019 and 2023 were collected.In vitro drug susceptibility testing was performed by the Kirby-Bauer disk diffusion (K-B) method, minimum inhibitory concentration method, and fully automated instrumentation, followed by analysis of the susceptibility results.
    RESULTS From 2019 to 2023, a total of 402 490 bacterial strains were isolated and cultured in Gansu Province, including 17 417 strains of E.cloacae, with a detection rate of 4.33%.The bacteria were primarily isolated from sputum specimens (62.81%), followed by urine (7.37%) and wound pus specimens (6.07%).The departmental distribution was dominated by internal medicine (44.96%) and surgery (28.50%).The highest detection rate was observed in the adult group (15-65 years, 45.79%).E.cloacae exhibited varying degrees of resistance to over 20 antibacterial drugs, but the overall drug resistance rate showed a declining trend (P < 0.05).The highest drug resistance rate was observed for cefazolin (96.40%-98.38%), while the lowest was for tigecycline (0.44%-2.92%).Carbapenem-resistant E.cloacae demonstrated an increasing trend in drug resistance rates, with imipenem resistance ranging from 2.79% to 3.71%(P=0.044) and meropenem resistance ranging from 1.29% to 3.41%(P < 0.05).
    CONCLUSIONS The isolation rate of E.cloacae in Gansu Province remains stable, with a declining trend in drug resistance to multiple antibacterial drugs.However, the increasing drug resistance to carbapenems warrants attention.

     

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