Drug resistance analysis of Enterobacter cloacae isolated from blood samples in Hebei, 2016-2021

Abstract

Objective To investigate the drug resistance of Enterobacter cloacae isolated from blood samples in 75 member units of the Bacterial Drug Resistance Monitoring Network in Hebei, 2016-2021, so as to provide a basis for rational drug use in clinic.

Methods WHONET 5.6 software was used to retrospectively analyze drug susceptibility of Enterobacter cloacae isolated from 32 secondary hospitals and 43 tertiary hospitals. SPSS19.0 software was used for statistical analysis.

Results After removing the duplicate strains, 1 225 strains of E. cloacae were isolated from blood samples of 75 hospitals during 6 years, including 157 strains from secondary hospitals and 1 068 strains from tertiary hospitals. In this study, the resistance of Enterobacter cloacae to 16 kinds of antibiotics was analyzed. The drug resistance rates to cefuroxime (52.4%-67.8%), piperacillin (27.4%-31.2%), ceftazidime (27.8%-35.5%), ceftriaxone (29.5%-45.0%), aztreonam (22.2%-32.3%), cotrimoxazole (21.6%-28.7%) were higher; the resistance rates to amikacin and tobramycin were lower than 15.0%. The resistance rates to imipenem and meropenem were 3.6%-12.3% and 5.1%-11.4%, respectively. The resistance rate to ciprofloxacin in tertiary hospitals was 22.4%, and the resistance rate to cotrimoxazole was 23.9%. Except for these two antimicrobials, the resistance rates to other antimicrobial drugs in tertiary hospitals were higher than that in secondary hospitals. A total of 121 carbapenem-resistant Enterobacter cloacae strains were detected in the past 6 years, with an increasing detection rate ( χ ² _trend=6.305, P=0.012).

Conclusions Enterobacter cloacae has great differences in antimicrobial resistance to different antibiotics, and is sensitive to carbapenems. The drug resistance in tertiary hospitals is generally higher than that in secondary hospitals. Drug resistance monitoring and drug resistance mechanism research should be strengthened to better guide clinical drug use and curb the rise of drug resistance.

Abstract

摘要： 目的 了解河北省细菌耐药监测网 75 家成员单位 2016—2021 年血标本分离的阴沟肠杆菌( Enterobacter cloacae)的耐药情况, 为临床合理用药提供依据。 方法 应用 WHONET5.6 软件回顾性分析 2016 年 1 月—2021 年 12 月 河北省细菌耐药监测网 75 家成员单位(包括 32 家二级医院, 43 家三级医院)血标本分离阴沟肠杆菌的药敏情况;应用 SPSS19.0软件进行统计分析。 结果 剔除重复菌株后, 75家医院 6年间血标本共分离出阴沟肠杆菌 1 225株, 其中二级 医院 157 株, 三级医院 1 068 株。本研究共分析了阴沟肠杆菌对 16 种抗菌药物的耐药情况, 其中, 对头孢呋辛(52.4%~67.8%)、哌拉西林(27.4%~31.2%)、头孢他啶(27.8%~35.5%)、头孢曲松(29.5%~45.0%)、氨曲南(22.2%~32.3%)、复方新 诺明(21.6%~28.7%)等抗生素耐药率较高;对阿米卡星、妥布霉素耐药率较低, 均<15.0%;对亚胺培南耐药率为 3.6%~ 12.3%, 美罗培南为 5.1%~11.4%。三级医院对环丙沙星耐药率为 22.4%, 对复方新诺明耐药率为 23.9%, 除这两种抗菌 药物外, 三级医院对其余抗菌药物的耐药性均高于二级医院。6年间共检出耐碳青霉烯类阴沟肠杆菌121株, 检出率有 上升趋势( χ ² _趋势=6.305, P=0.012)。 结论 阴沟肠杆菌对抗菌药物耐药性差异较大, 对碳青霉烯类抗生素较敏感。三级医院耐药性总体高于二级医院。应加强耐药性监测及耐药机制研究, 指导临床用药, 遏制耐药率上升。