临沂地区分离耐碳青霉烯类肠杆菌科细菌产酶型别与耐药性分析

目的:了解临沂地区碳青霉烯酶的基因型及耐碳青霉烯类肠杆菌科细菌（CRE）对头孢他啶-阿维巴坦（CAZ/AVI）的药物敏感性，为临床合理用药提供依据。方法:选取临沂市人民医院2019年1月至2020年12月临床标本分离获得的179株CRE，用改良碳青霉烯酶灭活试验（mCIM试验）和乙二胺四乙酸（EDTA）协同碳青霉烯酶灭...

Enzyme types and drug resistance of carbapenem-resistant Enterobacteriaceae isolated from Linyi area

Objective To detect the genotype of carbapenase and investigate the drug sensibility of Ceftazidime-avibactam(CAZ/AVI)on carbapenem-resistant Enterobacteriaceae(CRE),and to provide evidence for rational use of antibacterial drugs in clinical practice.Methods A total of 179 strains of CRE were isolated from clinical specimens of patients treated in Linyi People′s Hospital from January 2019 to December 2020.mCIM/eCIM test and GeneXpert were used to detect the genotype of carbapenemases.The drug sensibility of CAZ/AVI was detected by K-B test.Results One hundred and seventy-four out of 179 strains of CRE were positive upon to mCIM test(97.2%),147strains were positive upon to eCIM test(84.5%).There were 27 serine carbapenemase(15.5%)and 147 metallo-β-lactamase(84.5%).The results of Fluorescent quantitative PCR rapid detection system developed by Saipei GeneXpert were consistent with the results detected by mCIM/eCIM.In the drug sensitivity test,58 out of 174 mCIM positive strains were sensitive to CAZ(33.3%),of which the sensitivity of 27 strains producing serine carbapenemase was 96.3%(26/27)and all 147 strains producing metallo-β-lactamase were drug-resistant to CAZ/AVI.Conclusions The carbapenase genotype of CRE in Linyi region is mainly metalβ-lactamase.The CRE producing serine carbapenemase is highly sensitive to CAZ/AVI.It is helpful to guide the rational clinical use of the CAZ/AVI according to the detection results of CRE with or without carbapenemase production capacities.