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[临床感染标本中分离出的厌氧菌分布及耐药特征分析]

[Analysis on the distribution and drug resistance features of anaerobes isolated from clinical infectious specimens].

作者信息

Wang Y Y, Han Y Q, Guo S F, Fu Q, Wang J R

机构信息

Department of Clinical Laboratory, Affiliated Hospital of Inner Mongolian Medical University, Hohhot 010050, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2018 Sep 25;98(36):2894-2898. doi: 10.3760/cma.j.issn.0376-2491.2018.36.004.

Abstract

To clarify distribution and drug resistance characteristics of anaerobes isolated from clinical infectious samples, and to provide experimental data for guiding on treatment of infections caused by anaerobes. The anaerobes, isolated from 1 057 different clinical specimens from inpatients admitted to the Affiliated Hospital of Inner Mongolia Medical University from March 2016 to November 2017, were identified by VITEK-2 anaerobes and corynebacterium (ANC) card and bacteroides fragilis isolates were further verified by 16S-rRNA sequencing. Meanwhile, broth dilution method was employed to detect the drug sensititities of and PCR method was used to detect the carbapenem resistance gene cfiA. Totally 303 strains of anaerobic bacteria were isolated, among which 199 strains were gram-negative bacteria, accounted for 65.68%. Among the gram negative anaerobes, bacteroides species were the most common, accounted for 35.64%, followed by ., which accounted for 19.14%. . were the most common among ., accounted for 21.54%, accounted for 5.94%. The coincidence rate of 16S-rRNA sequencing results of and that of ANC card identification results was 100% (65/65). The drug resistance of . to penicillin, clidamycin, ampicillin/sulbactam, amoxicillin/clavulanic, were 100%, 90.77%, 56.92% and 66.67%, respectively. The resitance rate of . to chloramphenicol was the lowest, which was 1.54%.Moreover, the resistance rate of . to imipenem and metronidazole were both higher, which were 38.46%(25/65) and 23.08%(15/65), respectively, and the positive rate of beta lactamase was 100% (65/65). The carrying rate of carbapenems resistance gene cfiA for 65 strains of Bacteroides fragilis was 52.3% (34/65), and 72.00%(18/25)for imipenem resistant strains. The obligate anaerobic bacteria are widely distributed in clinical specimens, and the great majority are gram negative anaerobic bacteria, and the most frequently isolated one is . Bacteroides fragilis isolates are found to be resistant to several kinds of common antibiotics, especially for imipenem and metronidazole, which should be given more attention to.

摘要

为明确临床感染标本中分离出的厌氧菌的分布及耐药特征,为指导厌氧菌感染的治疗提供实验依据。对2016年3月至2017年11月内蒙古医科大学附属医院住院患者的1057份不同临床标本中分离出的厌氧菌,采用VITEK-2厌氧菌及棒状杆菌(ANC)鉴定卡进行鉴定,对脆弱拟杆菌分离株进一步采用16S-rRNA测序进行验证。同时,采用肉汤稀释法检测其药敏情况,采用PCR方法检测碳青霉烯耐药基因cfiA。共分离出303株厌氧菌,其中革兰阴性菌199株,占65.68%。在革兰阴性厌氧菌中,拟杆菌属最为常见,占35.64%,其次是……,占19.14%。……在……中最为常见,占21.54%,……占5.94%。……的16S-rRNA测序结果与ANC鉴定卡鉴定结果的符合率为100%(65/65)。……对青霉素、克林霉素、氨苄西林/舒巴坦、阿莫西林/克拉维酸的耐药率分别为100%、90.77%、56.92%和66.67%。……对氯霉素的耐药率最低,为1.54%。此外,……对亚胺培南和甲硝唑的耐药率均较高,分别为38.46%(25/65)和23.08%(15/65),β-内酰胺酶阳性率为100%(65/65)。65株脆弱拟杆菌碳青霉烯耐药基因cfiA携带率为52.3%(34/65),亚胺培南耐药株为72.00%(18/25)。专性厌氧菌在临床标本中分布广泛,绝大多数为革兰阴性厌氧菌,最常分离到的是……。发现脆弱拟杆菌分离株对多种常用抗生素耐药,尤其是对亚胺培南和甲硝唑,应予以更多关注。

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