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目的了解临床分离的59株碳青霉烯酶类抗生素耐药的肠杆菌科细菌(CRE)体外药敏情况。方法采用法国生物梅里埃公司VITEK-2Compact全自动细菌分析鉴定系统进行细菌鉴定及药敏,MALDI-TOF MS确认。琼脂稀释法测定临床常用抗生素的最低抑菌浓度。结果分离的菌株以肺炎克雷伯菌为主。59株CRE除对亚胺培南和美罗培南耐药率100.0%外,对哌拉西林/他巴唑坦和阿莫西林/克拉维酸同样完全耐药。头孢他啶、头孢噻肟、氨曲南耐药率分别为91.5%、98.5%和94.8%。阿米卡星有较好的抗菌活性,耐药率为44.8%。替加环素耐药率最低,为22.0%。结论 CRE耐药率较高,头孢类、青霉素类及其复合制剂单独用药不适合作为本地区CRE菌株抗菌药物,需联合用药。替加环素目前可作为CRE理想用药,阿米卡星也可作为次选。
Objective To investigate the in vitro susceptibility of 59 strains of carbapenem-resistant enterobacteriaceae (CRE) isolated from clinical isolates. Methods Bacterial identification and drug susceptibility were confirmed by MALDI-TOF MS using the VITEK-2 Compact automatic bacterial analysis system of French bioMérieux. Agar dilution method for the determination of antibiotics commonly used in clinical antibacterial minimum inhibitory concentration. Results The strains isolated were Klebsiella pneumoniae. 59 strains of CRE were equally resistant to piperacillin / methimazoline and amoxicillin / clavulanate except for resistance to imipenem and meropenem at 100.0%. Ceftazidime, cefotaxime, aztreonam resistance rates were 91.5%, 98.5% and 94.8%. Amikacin has good antibacterial activity, resistance rate was 44.8%. The lowest rate of tigecycline was 22.0%. Conclusions CRE resistance rate is high, cephalosporins, penicillins and their combination preparations alone are not suitable as CRE strains in the region antibacterial drugs, the need for combination therapy. Tigecycline is currently available as an ideal drug for CRE and amikacin as an alternative.