Distribution characteristics and drug resistance of carbapenem-resistant Enterobacteriaceae in chil-dren from 2016 to 2017
10.3760/cma.j.issn.0254-5101.2019.08.004
- VernacularTitle:2016—2017年儿童碳青霉烯类耐药肠杆菌科细菌的分布特点和耐药性分析
- Author:
Bingjie WANG
1
;
Fen PAN
;
Hong ZHANG
;
Ting ZHANG
;
Hongmei XU
;
Chunmei JING
;
Chuanqing WANG
;
Aimin WANG
;
Hui YU
;
Shuzhen HAN
;
Aiwei LIN
;
Shifu WANG
;
Qing CAO
;
Xing WANG
;
Chunzhen HUA
;
Yinghu CHEN
;
Xuejun CHEN
;
Jikui DENG
;
Ruizhen ZHAO
;
Huiling DENG
;
Sancheng CAO
;
Jianhua HAO
;
Wei GAO
;
Yiping CHEN
;
Jinhong YANG
Author Information
1. 上海交通大学附属儿童医院 上海市儿童医院检验科 200040
- Keywords:
Carbapenem-resistant Enterbacteriaceae;
Drug resistance;
Children
- From:Chinese Journal of Microbiology and Immunology
2019;39(8):583-590
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the distribution and drug resistance of carbapenem-resistant Enterobacteriaceae ( CRE) isolated from children in China. Methods CRE strains were collected in 10 ter-tiary children's hospitals of China from January 1, 2016 to December 31, 2017. Antimicrobial susceptibility of the clinical strains was detected with disk diffusion method ( KB method) and automated method. The re-sults were analyzed according to the Clinical and Laboratory Standards Institute ( CLSI) Standards published in 2017. WHONET 5. 6 software was used to retrospectively analyze the distribution characteristics and drug resistance of these strains. Results A total of 3065 CRE clinical strains were isolated from children with an overall prevalence of 7. 7％ and among them, 13. 5％ were isolated in neonatal group and 5. 8％ in non-neo-natal group. The detection rate of CRE in 2017 was higher than that in 2016 (9. 7％ vs 5. 7％). Among the 3065 CRE strains, there were 1912 strains of Klebsiella pneumoniae (62. 0％), 667 strains of Escherichia coli (22. 0％), 206 strains of Enterobacter cloacae (7. 0％), 56 strains of Klebsiella aerogenes (1. 8％) and 47 strains of Serratia marcescens (1. 5％). Most of the strains were isolate in neonatology departments including neonatal intensive care units (NICU) and intensive care units (ICU), accounting for 44. 8％ and 19. 7％, respectively. Respiratory tract (61. 8％), urine (19. 4％) and blood (5. 7％) specimens were the main sources of CRE isolates. Results of antimicrobial susceptibility test showed that the CRE strains were highly resistant to carbapenem antibiotics such as imipenem, meropenem and ertapenem, as well as penicillins and most cephalosporins (79. 6％-100％), especially those isolated in the neonatal group (P<0. 05). Children had relatively low resistance rates to aminoglycosides such as amikacin (19. 7％) and fos-fomycin (11. 9％), fluoroquinolones such as levofloxacin (37. 7％) and ciprofloxacin (43. 3％), and tige-cycline (3. 8％). Currently, no polymyxin B-resistant strains were isolated. Conclusions The prevalence of common CRE strains in children in 2017 was higher than that in 2016, especially in newborns. Drug re-sistance in CRE strains isolated from neonates to common antibiotics was more severe, suggesting that great attention should be paid to it and timely measures should also be taken.
