Analysis of distribution characteristics and nosocomial infection of carbazene-resistant Enterobacteriaceae in a general hospital of traditional Chinese medicine from 2014 to 2018_West China Medical Journal

Authors：

HE Qian ¹ ,  ZHAO Hong ¹ , KE Yinfeng ¹ , ZHANG Changfeng ² , LI Xiaona ¹ , XU Yufei ³

1. Hospital Infection Management Section, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Anhui, Hefei 230031, P. R. China;
2. Microbiology Room, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Anhui, Hefei 230031, P. R. China;
3. Department of Economics and Management, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Anhui, Hefei 230031, P. R. China;

Corresponding author：

ZHAO Hong, Email: 487985728@qq.com

Keywords：

Multidrug-resistant bacteria; Carbapenem-resistant Enterobacteriaceae; Nosocomial infection

DOI：

10.7507/1002-0179.201912085

Video：

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Objective To understand the distribution characteristics and nosocomial infection of carbapenem-resistant Enterobacteriaceae (CRE) in a general hospital of traditional Chinese medicine, so as to provide the evidence for control and management of multidrug-resistant bacteria.Methods Data of CRE in the first Affiliated Hospital of Anhui University of Traditional Chinese Medicine were analyzed retrospectively from 2014 to 2018.Results The total detection rate of CRE was 10.76%, 5.58%, 15.42%, 12.94% and 16.18% from 2014 to 2018, respectively. The detection rate of CRE showed a gradual upward trend (χ²=29.940, P<0.001). The highest number of CRE isolated from clinical specimens was sputum (355 strains, 63.39%), and the next were urine (98 strains, 17.50%) and secretions (38 strains, 6.79%). CRE isolated from different clinical departments were mainly in Neurosurgery Department (172 stains, 30.71%), Intensive Care Unit (Internal Medicine) (145 strains, 25.89%), Intensive Care Unit (Surgery)(106 strains,18.93%), and other internal medical departments (83 strains, 14.82%). A total of 179 patients developed CRE nosocomial infection in the past 5 years, who were mainly male, and with advanced age, long hospital stay, basic diseases, abnormal immune function and invasive operation. The incidence of hospital infection with CRE from 2014 to 2018 were 0.31‰, 0.38‰, 0.89‰, 0.80‰ and 1.14‰, respectively, which also showed a gradual upward trend (χ²=25.111, P<0.001).Conclusion With the increasing number of clinically isolated CRE strains and the increasing incidence of nosocomial infection of CRE, effective intervention measures should be taken to prevent and control CRE.

Citation： HE Qian, ZHAO Hong, KE Yinfeng, ZHANG Changfeng, LI Xiaona, XU Yufei. Analysis of distribution characteristics and nosocomial infection of carbazene-resistant Enterobacteriaceae in a general hospital of traditional Chinese medicine from 2014 to 2018. West China Medical Journal, 2020, 35(3): 301-306. doi: 10.7507/1002-0179.201912085 Copy

1.	周仕丹, 刘春来, 杨润时, 等. 某院耐碳青霉烯类肠杆菌科细菌耐药基因分析. 中国感染控制杂志, 2019, 18(6): 495-504.
2.	胡付品, 朱德妹, 汪复, 等. 2015 年 CHINET 细菌耐药性监测. 中国感染与化疗杂志, 2016, 16(6): 685-694.
3.	CLSI. Performance standards for antimicrobial susceptibility tesing: M100-S27. Wayne, PA: CLSI, 2017: 107-127.
4.	中华人民共和国卫生部. 医院感染诊断标准(试行). 中华医学杂志, 2001, 81(5): 314-320.
5.	孟秀娟, 吴安华. 如何应对多重耐药菌医院感染的严峻挑战. 中国感染控制杂志, 2019, 18(3): 185-191.
6.	胡付品, 郭燕, 朱德妹, 等. 2017 年 CHINET 中国细菌耐药性监测. 中国感染与化疗杂志, 2018, 18(3): 241-251.
7.	刘刚, 魏莲花, 邹凤梅, 等. 2011-2016 年耐碳青霉烯类抗菌药物肠杆菌科细菌的分布特点和耐药性分析. 中国医药科学, 2018, 8(9): 20-23.
8.	赵慧铮, 师志云, 李刚, 等. 耐碳青霉烯类肠杆菌科细菌耐药性分析与分子流行病学研究. 中华医院感染学杂志, 2016, 26(3): 494-497.
9.	胡付品, 朱德妹, 汪夏, 等. 2012 年中国 CHINET 碳青霉烯类耐药肠杆菌科细菌的分布特点和耐药性分析. 中国感染与化疗杂志, 2014, 14(5): 382-386.
10.	黄汉, 郭鹏豪, 陈怡丽, 等. 产碳青霉烯酶肠杆菌科细菌的筛查. 国际检验医学杂志, 2014, 35(8): 985-986.
11.	Palacios-Baena ZR, Oteo J, Conejo C, et al. Comprehensive clinical and epidemiological assessment of colonisation and infection due to carbapenemase-producing Enterobacteriaceae in Spain. J Infect, 2016, 72(2): 152-160.
12.	Cunha CB, Kassakian SZ, Chan R, et al. Screening of nursing home residents for colonization with carbapenem-resistant Enterobacteriaceae admitted to acute care hospitals: incidence and risk factors. Am J Infect Control, 2016, 44(2): 126-130.
13.	Perez LR, Rodrigues D, Dias CG. Evaluation of phenotypic tests to detect carbapenem-resistant Enterobacteriaceae in colonized patients hospitalized in intensive care units. Braz J Infect Dis, 2015, 19(4): 436-438.
14.	Satlin MJ, Chen L, Patel G, et al. Multicenter clinical and molecular epidemiological analysis of bacteremia due to carbapenem-resistant Enterobacteriaceae (CRE) in the CRE epicenter of the United States. Antimicrob Agents Chemother, 2017, 61(4): pii: e02349-16.
15.	Tang Y, Shen P, Liang W, et al. A putative multi-replicon plasmid co-harboring beta-lactamase genes blaKPC-2, blaCTX-M-14 and blaTEM-1 and trimethoprin resistance gene dfrA25 froma Klebsiella pneumoniae sequence type (ST) 11 strain in China. PLoS One, 2017, 12(2): e0171339.
16.	刘周, 李昕, 储雯雯, 等. 碳青霉烯耐药肠杆菌科细菌临床分布及耐药特征分析. 安徽医学, 2018, 39(3): 274-277.
17.	张昭勇, 杨宏伟, 喻飞, 等. 碳青霉烯耐药肠杆菌科细菌医院感染危险因素的病例对照研究. 国际检验医学杂志, 2018, 39(13): 1573-1577, 1581.
18.	李勇, 黄露萍, 晏坤, 等. 某院耐碳青霉烯类肠杆菌科细菌的分布及耐药性分析. 临床输血与检验, 2018, 20(1): 57-60.
19.	Friedman ND, Carmeli Y, Walton AL, et al. Carbapenem-resistant Enterobacteriaceae: a strategic roadmap for infection control. Infect Control Hosp Epidemiol, 2017, 38(5): 580-594.
20.	Bogan C, Kaye KS, Chopra T, et al. Outcomes of carbapenem-resistant Enterobacteriaceae isolation: matched analysis. Am J Infect Control, 2014, 42(6): 612-620.
21.	O’Horo JC, Farrell A, Sohail MR, et al. Carbapenem-resistant Enterobacteriaceae and endoscopy: an evolving threat. Am J Infect Control, 2016, 44(9): 1032-1036.
22.	Bitterman R, Geffen Y, Rabino G, et al. Rate of colonization of health care workers by carbapenem-resistant Enterobacteriaceae in an endemic hospital: a prospective study. Am J Infect Control, 2016, 44(9): 1053-1054.
23.	胡付品, 朱德妹. 医疗机构碳青霉烯类耐药肠杆菌科细菌感染防控指南简介. 中国感染与化疗杂志, 2018, 18(3): 331-335.
24.	Bartsch SM, McKinnell JA, Mueller LE, et al. Potential economic burden of carbapenem-resistant Enterobacteriaceae (CRE) in the United States. Clin Microbiol Infect, 2017, 23(1): 48.e9-48.e16.
25.	Falagas ME, Tansarli GS, Karageorgopoulos DE, et al. Deaths attributable to carbapenem-resistant Enterobacteriaceae infections. Emerg Infect Dis, 2014, 20(7): 1170-1175.
26.	乔甫, 程棣妍, 司徒永康. 防控产碳青霉烯酶的肠杆菌科细菌新观点. 华西医学, 2019, 34(3): 233-242.
27.	乔甫, 黄文治, 宗志勇. 多重耐药菌感染防控的意义与发展趋势. 中国护理管理, 2019, 19(8): 1129-1134.

1. 周仕丹, 刘春来, 杨润时, 等. 某院耐碳青霉烯类肠杆菌科细菌耐药基因分析. 中国感染控制杂志, 2019, 18(6): 495-504.
2. 胡付品, 朱德妹, 汪复, 等. 2015 年 CHINET 细菌耐药性监测. 中国感染与化疗杂志, 2016, 16(6): 685-694.
3. CLSI. Performance standards for antimicrobial susceptibility tesing: M100-S27. Wayne, PA: CLSI, 2017: 107-127.
4. 中华人民共和国卫生部. 医院感染诊断标准(试行). 中华医学杂志, 2001, 81(5): 314-320.
5. 孟秀娟, 吴安华. 如何应对多重耐药菌医院感染的严峻挑战. 中国感染控制杂志, 2019, 18(3): 185-191.
6. 胡付品, 郭燕, 朱德妹, 等. 2017 年 CHINET 中国细菌耐药性监测. 中国感染与化疗杂志, 2018, 18(3): 241-251.
7. 刘刚, 魏莲花, 邹凤梅, 等. 2011-2016 年耐碳青霉烯类抗菌药物肠杆菌科细菌的分布特点和耐药性分析. 中国医药科学, 2018, 8(9): 20-23.
8. 赵慧铮, 师志云, 李刚, 等. 耐碳青霉烯类肠杆菌科细菌耐药性分析与分子流行病学研究. 中华医院感染学杂志, 2016, 26(3): 494-497.
9. 胡付品, 朱德妹, 汪夏, 等. 2012 年中国 CHINET 碳青霉烯类耐药肠杆菌科细菌的分布特点和耐药性分析. 中国感染与化疗杂志, 2014, 14(5): 382-386.
10. 黄汉, 郭鹏豪, 陈怡丽, 等. 产碳青霉烯酶肠杆菌科细菌的筛查. 国际检验医学杂志, 2014, 35(8): 985-986.
11. Palacios-Baena ZR, Oteo J, Conejo C, et al. Comprehensive clinical and epidemiological assessment of colonisation and infection due to carbapenemase-producing Enterobacteriaceae in Spain. J Infect, 2016, 72(2): 152-160.
12. Cunha CB, Kassakian SZ, Chan R, et al. Screening of nursing home residents for colonization with carbapenem-resistant Enterobacteriaceae admitted to acute care hospitals: incidence and risk factors. Am J Infect Control, 2016, 44(2): 126-130.
13. Perez LR, Rodrigues D, Dias CG. Evaluation of phenotypic tests to detect carbapenem-resistant Enterobacteriaceae in colonized patients hospitalized in intensive care units. Braz J Infect Dis, 2015, 19(4): 436-438.
14. Satlin MJ, Chen L, Patel G, et al. Multicenter clinical and molecular epidemiological analysis of bacteremia due to carbapenem-resistant Enterobacteriaceae (CRE) in the CRE epicenter of the United States. Antimicrob Agents Chemother, 2017, 61(4): pii: e02349-16.
15. Tang Y, Shen P, Liang W, et al. A putative multi-replicon plasmid co-harboring beta-lactamase genes blaKPC-2, blaCTX-M-14 and blaTEM-1 and trimethoprin resistance gene dfrA25 froma Klebsiella pneumoniae sequence type (ST) 11 strain in China. PLoS One, 2017, 12(2): e0171339.
16. 刘周, 李昕, 储雯雯, 等. 碳青霉烯耐药肠杆菌科细菌临床分布及耐药特征分析. 安徽医学, 2018, 39(3): 274-277.
17. 张昭勇, 杨宏伟, 喻飞, 等. 碳青霉烯耐药肠杆菌科细菌医院感染危险因素的病例对照研究. 国际检验医学杂志, 2018, 39(13): 1573-1577, 1581.
18. 李勇, 黄露萍, 晏坤, 等. 某院耐碳青霉烯类肠杆菌科细菌的分布及耐药性分析. 临床输血与检验, 2018, 20(1): 57-60.
19. Friedman ND, Carmeli Y, Walton AL, et al. Carbapenem-resistant Enterobacteriaceae: a strategic roadmap for infection control. Infect Control Hosp Epidemiol, 2017, 38(5): 580-594.
20. Bogan C, Kaye KS, Chopra T, et al. Outcomes of carbapenem-resistant Enterobacteriaceae isolation: matched analysis. Am J Infect Control, 2014, 42(6): 612-620.
21. O’Horo JC, Farrell A, Sohail MR, et al. Carbapenem-resistant Enterobacteriaceae and endoscopy: an evolving threat. Am J Infect Control, 2016, 44(9): 1032-1036.
22. Bitterman R, Geffen Y, Rabino G, et al. Rate of colonization of health care workers by carbapenem-resistant Enterobacteriaceae in an endemic hospital: a prospective study. Am J Infect Control, 2016, 44(9): 1053-1054.
23. 胡付品, 朱德妹. 医疗机构碳青霉烯类耐药肠杆菌科细菌感染防控指南简介. 中国感染与化疗杂志, 2018, 18(3): 331-335.
24. Bartsch SM, McKinnell JA, Mueller LE, et al. Potential economic burden of carbapenem-resistant Enterobacteriaceae (CRE) in the United States. Clin Microbiol Infect, 2017, 23(1): 48.e9-48.e16.
25. Falagas ME, Tansarli GS, Karageorgopoulos DE, et al. Deaths attributable to carbapenem-resistant Enterobacteriaceae infections. Emerg Infect Dis, 2014, 20(7): 1170-1175.
26. 乔甫, 程棣妍, 司徒永康. 防控产碳青霉烯酶的肠杆菌科细菌新观点. 华西医学, 2019, 34(3): 233-242.
27. 乔甫, 黄文治, 宗志勇. 多重耐药菌感染防控的意义与发展趋势. 中国护理管理, 2019, 19(8): 1129-1134.

West China Medical Journal

Analysis of distribution characteristics and nosocomial infection of carbazene-resistant Enterobacteriaceae in a general hospital of traditional Chinese medicine from 2014 to 2018

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