关键词: 耐碳青霉烯类, 肠杆菌科细菌, 分布, 耐药性

Abstract: Objective To explore clinical distribution and drug resistance of carbapenem-resistant Enterobacteriaceae and provide basis for clinical rational use of antibiotics．Methods Carbapenemase phenotypes were detected in identified 46 CRE by modified Hodge test．The strains and their drug sensitivity tests were performed by VITEK-2 automatic bacteria identification system . The antimicrobial susceptibility Results were evaluated according to CLSI 2012 standard and analyzed with WHONET 5.6 software．Results 82.61% of 46 CRE isolates were identified to be Klebsiella pneumoniae． Those infected patients were mainly from intensive care units（ICU）,accounting for 50.0%, and infection site located at the lower respiratory tract（69.57%）. A total of 38 stains from 46 isolated stains were positive in modified Hodge test. Analysis of the 46 CRE during last two years,we found that 9 of them were pan drug-resistant（19.6%）,but the resistance rates of CRE isolates to other antimicrobial agents were all in 70%-100%,and all appear in this recent year. The resistant rates of the CRE in the year from September 2014 to September 2015 to aminoglycoside drug amikacin,tobramycin and gentamicin were dramatically increased to which from September 2015 to September 2016（from 19.0%,19.0% and 23.8% to 96.0% and 88.0%,96.0% respectively）,and resistant rates to the Compound sulfamethoxazole and nitrofurantoin were slightly decreased（from 85.7% and 100% to 65.8% and 80% respectively）. Conclusion The CRE isolates were mainly isolated from specimen of sputum in ICU and there was multiple drug resistance trend. The Drug resistance surveillance should be strengthened to guide the clinical medication and to reduce the emergence of drug resistant strains.

Key words: Carbapenem-resistant, Enterobacteriaceae, Distribution, Drug resistance