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, 劉春來, 楊潤時, 等. 某院耐碳青霉烯類腸桿菌科細菌耐藥基因分析. 中國感染控制雜志, 2019, 18(6): 495-504.
2.	胡付品, 朱德妹, 汪復, 等. 2015 年 CHINET 細菌耐藥性監測. 中國感染與化療雜志, 2016, 16(6): 685-694.
3.	CLSI. Performance standards for antimicrobial susceptibility tesing: M100-S27. Wayne, PA: CLSI, 2017: 107-127.
4.	中華人民共和國衛生部. 醫院感染診斷標準(試行). 中華醫學雜志, 2001, 81(5): 314-320.
5.	孟秀娟, 吳安華. 如何應對多重耐藥菌醫院感染的嚴峻挑戰. 中國感染控制雜志, 2019, 18(3): 185-191.
6.	胡付品, 郭燕, 朱德妹, 等. 2017 年 CHINET 中國細菌耐藥性監測. 中國感染與化療雜志, 2018, 18(3): 241-251.
7.	劉剛, 魏蓮花, 鄒鳳梅, 等. 2011-2016 年耐碳青霉烯類抗菌藥物腸桿菌科細菌的分布特點和耐藥性分析. 中國醫藥科學, 2018, 8(9): 20-23.
8.	趙慧錚, 師志云, 李剛, 等. 耐碳青霉烯類腸桿菌科細菌耐藥性分析與分子流行病學研究. 中華醫院感染學雜志, 2016, 26(3): 494-497.
9.	胡付品, 朱德妹, 汪夏, 等. 2012 年中國 CHINET 碳青霉烯類耐藥腸桿菌科細菌的分布特點和耐藥性分析. 中國感染與化療雜志, 2014, 14(5): 382-386.
10.	黃漢, 郭鵬豪, 陳怡麗, 等. 產碳青霉烯酶腸桿菌科細菌的篩查. 國際檢驗醫學雜志, 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.	劉周, 李昕, 儲雯雯, 等. 碳青霉烯耐藥腸桿菌科細菌臨床分布及耐藥特征分析. 安徽醫學, 2018, 39(3): 274-277.
17.	張昭勇, 楊宏偉, 喻飛, 等. 碳青霉烯耐藥腸桿菌科細菌醫院感染危險因素的病例對照研究. 國際檢驗醫學雜志, 2018, 39(13): 1573-1577, 1581.
18.	李勇, 黃露萍, 晏坤, 等. 某院耐碳青霉烯類腸桿菌科細菌的分布及耐藥性分析. 臨床輸血與檢驗, 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. 醫療機構碳青霉烯類耐藥腸桿菌科細菌感染防控指南簡介. 中國感染與化療雜志, 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.	喬甫, 程棣妍, 司徒永康. 防控產碳青霉烯酶的腸桿菌科細菌新觀點. 華西醫學, 2019, 34(3): 233-242.
27.	喬甫, 黃文治, 宗志勇. 多重耐藥菌感染防控的意義與發展趨勢. 中國護理管理, 2019, 19(8): 1129-1134.

1. 周仕丹, 劉春來, 楊潤時, 等. 某院耐碳青霉烯類腸桿菌科細菌耐藥基因分析. 中國感染控制雜志, 2019, 18(6): 495-504.
2. 胡付品, 朱德妹, 汪復, 等. 2015 年 CHINET 細菌耐藥性監測. 中國感染與化療雜志, 2016, 16(6): 685-694.
3. CLSI. Performance standards for antimicrobial susceptibility tesing: M100-S27. Wayne, PA: CLSI, 2017: 107-127.
4. 中華人民共和國衛生部. 醫院感染診斷標準(試行). 中華醫學雜志, 2001, 81(5): 314-320.
5. 孟秀娟, 吳安華. 如何應對多重耐藥菌醫院感染的嚴峻挑戰. 中國感染控制雜志, 2019, 18(3): 185-191.
6. 胡付品, 郭燕, 朱德妹, 等. 2017 年 CHINET 中國細菌耐藥性監測. 中國感染與化療雜志, 2018, 18(3): 241-251.
7. 劉剛, 魏蓮花, 鄒鳳梅, 等. 2011-2016 年耐碳青霉烯類抗菌藥物腸桿菌科細菌的分布特點和耐藥性分析. 中國醫藥科學, 2018, 8(9): 20-23.
8. 趙慧錚, 師志云, 李剛, 等. 耐碳青霉烯類腸桿菌科細菌耐藥性分析與分子流行病學研究. 中華醫院感染學雜志, 2016, 26(3): 494-497.
9. 胡付品, 朱德妹, 汪夏, 等. 2012 年中國 CHINET 碳青霉烯類耐藥腸桿菌科細菌的分布特點和耐藥性分析. 中國感染與化療雜志, 2014, 14(5): 382-386.
10. 黃漢, 郭鵬豪, 陳怡麗, 等. 產碳青霉烯酶腸桿菌科細菌的篩查. 國際檢驗醫學雜志, 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. 劉周, 李昕, 儲雯雯, 等. 碳青霉烯耐藥腸桿菌科細菌臨床分布及耐藥特征分析. 安徽醫學, 2018, 39(3): 274-277.
17. 張昭勇, 楊宏偉, 喻飛, 等. 碳青霉烯耐藥腸桿菌科細菌醫院感染危險因素的病例對照研究. 國際檢驗醫學雜志, 2018, 39(13): 1573-1577, 1581.
18. 李勇, 黃露萍, 晏坤, 等. 某院耐碳青霉烯類腸桿菌科細菌的分布及耐藥性分析. 臨床輸血與檢驗, 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. 醫療機構碳青霉烯類耐藥腸桿菌科細菌感染防控指南簡介. 中國感染與化療雜志, 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. 喬甫, 程棣妍, 司徒永康. 防控產碳青霉烯酶的腸桿菌科細菌新觀點. 華西醫學, 2019, 34(3): 233-242.
27. 喬甫, 黃文治, 宗志勇. 多重耐藥菌感染防控的意義與發展趨勢. 中國護理管理, 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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