Drug resistance and molecular epidemiology of carbapenem resistant Enterobacteriaceae bacteria in a tertiary hospital in the past 5 years
10.3969/j.issn.1673-4130.2024.24.012
- VernacularTitle:近5年某三甲医院耐碳青霉烯类肠杆菌科细菌耐药性及分子流行病学研究
- Author:
Wenjun ZHU
1
;
Yan WANG
;
Xia LIU
;
Minghui LI
;
Yue WU
;
Juan HU
Author Information
1. 连云港市第二人民医院/南京医科大学康达学院附属连云港第二人民医院,江苏连云港 222023
- Keywords:
carbapenem resistant Escherichia coli;
carbapenem resistant Klebsiella pneumoniae;
car-bapenem resistant Escherichia coli;
clinical prevalence distribution;
drug resistance characteristics
- From:
International Journal of Laboratory Medicine
2024;45(24):3004-3009
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical distribution characteristics,drug resistance,and homology of carbapenem resistant Escherichia coli(CRE)isolated from a tertiary hospital from 2019 to 2023,in order to provide a basis for rational drug use and hospital infection prevention and control.Methods A retrospective a-nalysis was conducted on non repetitive CRE strains clinically isolated from 2019 to 2023 in the hospital.WHONET 5.6 software was used to analyze the isolation rate,clinical distribution characteristics,and patho-gen resistance of CRE strains.CRE strains clinically isolated in 2022 in the hospital were collected as research objects,and the resistance gene expression and homology with hospital acquired infection clones were detected through polymerase chain reaction amplification and sequence analysis.Results From 2019 to 2023,a total of 455 non duplicated CRE strains were detected in clinical specimens of the hospital,with a detection rate of 6.00％.The annual detection rates were 72 strains(6.59％)in 2019,91 strains(8.31％)in 2020,117 strains(7.99％)in 2021,78 strains(4.76％)in 2022,and 97 strains(4.24％)in 2023.The CRE detection rates showed a downward trend from 2020 to 2023(P＜0.05).The top two strains in terms of proportion among CRE strains were 324 strains(71.21％)of carbapenem resistant Klebsiella pneumoniae(CRKP)and 57 strains(12.53％)of carbapenem resistant Escherichia coli(CREC).In addition,the detection rate of CRKP showed a decreasing trend from 2021 to 2023,while the detection rate of CREC showed an increasing trend from 2021 to 2023(P＜0.05).The strains mainly came from intensive care medicine,geriatrics,and neurology departments.Most of the CRE strains were isolated from sputum samples,with a detection rate of 67.96％,followed by urine samples with a detection rate of 21.97％.CRE had a very high resistance to common clinical antibiotics,with resistance rates of 94.32％and 96.37％to ertapenem and imipenem,respectively.Out of 78 strains of CRE,55 strains(70.51％)were found to have blaKPC-2 genotype and 14 strains(17.95％)were found to have blaNDM genotype.The detection rate of CRKP MLST typing ST11 was 68.89％(31/45).Con-clusion The detection rate of CRE in the hospital is showing a downward trend,but the resistance of the strains is still high.CRKP is the main strain of CRE strains,mainly carrying blaKPC-2 gene,and ST11 type is the main one.Clinical departments(especially critical care departments)should choose antibiotics reasonably based on the results of drug sensitivity tests for treatment and strengthen hospital management to further curb the growth of CRE.
