Occurrence of false positive results for the detection of carbapenemases in carbapenemase-negative Escherichia coli and Klebsiella pneumoniae isolates

Adequate detection of the production of carbapenemase in Enterobacteriaceae isolates is crucial for infection control measures and the appropriate choice of antimicrobial therapy. In this study, we investigated the frequency of false positive results for the detection of carbapenemases in carbapenemase-negative Escherichia coli and Klebsiella pneumoniae clinical isolates by the modified Hodge test (MHT). Three hundred and one E. coli and K. pneumoniae clinical isolates were investigated. All produced extended spectrum β-lactamases (ESBLs) but were susceptible to carbapenems. Antimicrobial susceptibility testing was performed by the disk diffusion and agar dilution methods. The MHT was performed using the standard inoculum of test organisms recommended by the CLSI. Genes that encoded ESBLs and carbapenemases were identified by PCR and DNA sequencing. Among the 301 clinical isolates, none of the isolates conformed to the criteria for carbapenemase screening recommended by the CLSI. The susceptibility rates for imipenem, meropenem, and ertapenem all were 100.0%, 100.0%, and 100.0%, respectively. Of the 301 E. coli and K. pneumoniae isolates, none produced carbapenemase. The MHT gave a positive result for 3.3% (10/301) of the isolates. False positive results can occur when the MHT is used to detect carbapenemase in ESBL-producing isolates and clinical laboratories must be aware of this fact.     

头孢西丁耐药肺炎克雷伯菌AmpC基因和ESBLs检测及耐药性分析

目的了解深圳地区头孢西丁耐药肺炎克雷伯菌头孢菌素酶(AmpC酶)基因型分布、产超广谱β-内酰胺酶(ESBLs)的情况及其耐药特点。方法收集深圳地区三家大型综合医院临床标本分离对头孢西丁耐药的肺炎克雷伯菌73株。用碱裂解法提取菌株的质粒,采用多重PCR扩增AmpC基因,应用DNA测序确定其基因型。并对所有菌株进行ESBLs表型确证试验;用K-B法对其进行药物敏感试验。结果 48株(65.8%)AmpC基因扩增阳性,经DNA测序显示,其中46株为DHA-1型,1株为CMY-2型,1株同时产DHA-1和CMY-2型;73株肺炎克雷伯菌中49株ESBLs阳性,其中36株AmpC基因和ESBLs均为阳性。AmpC和(或)ESBLs阳性菌株对多数药物的耐药率高于AmpC和ESBLs均阴性者。结论本地区头孢西丁耐药肺炎克雷伯菌质粒AmpC酶检出率高,基因型主要为DHA-1,同时产AmpC酶和ESBLs菌株较常见。     

Prevalence and antimicrobial resistance of extended-spectrum beta-lactamases-producing Escherichia coli and Klebsiella pneumoniae strains isolated in a university hospital in Split, Croatia.

The prevalence of Escherichia coli and Klebsiella pneumoniae that produce extended-spectrum b-lactamases (ESBL) was investigated in patients of a university hospital in Split, Croatia. Patients were grouped according to age (pediatric vs. adult), antibiotic type, and hospital ward. From Jan. 2001 to Dec. 2002, the susceptibility of E. coli and K. pneumoniae isolates to antimicrobials was tested. ESBL production was assayed using the double-disk synergy test. ESBL-producing E. coli and K. pneumoniae were detected in all sites of infection sampled. The percentages of ESBL-positive isolates were higher in the pediatric wards than in the adult wards. The antibiotics most commonly prescribed to patients in all hospital wards belonged to the third-generation cephalosporin group. Among ESBL producers, E. coli isolates were more resistant to aminoglycosides, but less resistant to ciprofloxacin and cotrimoxazole. Resistance of E. coli and K. pneumoniae to ciprofloxacin was exclusively found in isolates from adult patients. None of the isolates, regardless of ESBL production, was resistant to carbapenemes. In addition, the prevalence and antimicrobial resistance of ESBL-producing E. coli and K. pneumoniae isolates differed between pediatric and adult patients.     

Molecular epidemiology of ESbetaL producing P. mirabilis strains from a long-term care and rehabilitation facility in Italy

We report the detection of multidrug resistant ESbetaL producing Proteus mirabilis isolates from a long-term care and rehabilitation facility (LTCRF) in Northern Italy. 53% of the collected P. mirabilis strains were ESbetaL producers. PCR and sequencing techniques confirmed the presence of the bla(TEM-92) and bla(CMY-16) resistance genes in 23/26 (88.5%) and 3/26 (11.5%) of the ESbetaL producers respectively. PFGE showed that the TEM-92 beta-lactamase producing isolates were not clonally related, indicating the presence of at least four different clonal lineages (A, B, C, D), whereas all the CMY-16 enzyme producers belonged in the same lineage. The bla(TEM-92) and bla(CYY-16) determinants were distributed in seven different wards, but in three of them they coexisted. Our results show that the most patients are co-colonized by ESbetaLs producing P. mirabilis strains at the time of admission to an LTCRF. An effective strategy to curtail the spread of ESbetaLs mediated resistance in LTCRFs could be to activate sourveillance programs to monitor routinely the entry of resistant bacteria.     

Sensitivity to selected beta-lactam antibiotics of clinical strains of Escherichia coli and Klebsiella pneumoniae

The studies aimed at analysing the resistance to some beta-lactam antibiotics among E. coli and K. pneumoniae clinical isolates and at evaluating. The extended spectrum of beta-lactamases (ESBL) production in the isolates. The analysis included 137 E. coli strains and 52 K. pneumoniae strains, isolated from hospitalized patients and out-patients treated in the first trimester of 1998. The strains were identified using the ATB computer system. Antibiotic sensitivity of the isolates was determined by disc-diffusion tests. ESBL production capacity of E. coli and K. pneumoniae strains was estimated by double-disc and ATB BLSA tests. Most of the analysed E. coli strains were found to exhibit significant sensitivity to compound penicillin preparations containing beta-lactam inhibitor (Augmentin, Tazocin) and to the third generation cefalosporins, in contrast, K. pneumoniae strains much more frequently were resistant to the drugs. Among the obtained isolates, 3 (2.2%) E. coli strains and 21 (40.4%) K. pneumoniae strains produced ESBL but all the isolates proved sensitive to imipenem. In evaluation of ESBL production-detecting tests, the double-disc test was found to be more reliable than ATB BLSA test.     

379株血培养病原菌的临床分布及耐药性分析

目的了解血培养病原菌种类、临床分布及耐药情况。方法对2008年6月至2009年6月的379株血培养病原菌及其药敏情况用WHONET5.4软件进行统计分析。结果 379株病原菌中,分离率从高到低依次是凝固酶阴性葡萄球菌(133/35.1%)、大肠埃希菌(44/11.6%)、肺炎克雷伯菌(32/8.4%)、鲍曼不动杆菌(30/7.9%)、铜绿假单胞菌(25/6.6%)、金黄色葡萄球菌(18/4.7%)、肠球菌(13/3.4%)和其他(75/22.2%)。这些菌株主要分布在ICU和普外科。药敏结果分析显示:革兰阳性球菌中,未发现利奈唑胺和万古霉素耐药株。金黄色葡萄球菌和凝固酶阴性葡萄球菌对苯唑西林的耐药率分别为61.1%和89.5%;屎肠球菌对多数抗生素耐药率超过80%,粪肠球菌对青霉素类抗生素敏感性较高。革兰阴性杆菌中,大肠埃希菌和肺炎克雷伯菌中产ESBLs菌株比例分别为36.4%和31.3%,且发现2株耐亚胺培南的肺炎克雷伯菌;鲍曼不动杆菌除对卡那霉素保持敏感外,对其他抗生素的耐药率为50%~100%;铜绿假单胞菌对头孢曲松的耐药率为100%,对其他β-内酰胺类抗生素、氨基糖苷类和喹诺酮类抗生素的耐药率相对较低。结论临床上应规范血培养标本留取方法以减少污染,加强细菌耐药监测、严格抗生素使用,以延缓细菌耐药情况的发生和发展。     

2009年度宁波市妇儿医院主要病原菌的临床分布及耐药性分析

目的了解宁波市妇儿医院主要病原菌的临床分布及耐药性分析。方法血液培养采用法国生物梅里埃公司的BacT/Alert3D,菌株鉴定采用法国生物梅里埃公司的VITEK 60分析仪,药敏试验采用K-B法,纸片扩散确证试验检测ESBLs。结果前10位细菌构成比依次是大肠埃希菌(13.4%)、白色念珠菌(8.7%)、阴道加德纳菌(7.8%)、表皮葡萄球菌(6.9%)、金黄色葡萄球菌(5.6%)、肺炎克雷伯菌(4.9%)、鲍曼复合醋酸钙不动杆菌(3.9%)、粪肠球菌(D群)(3.1%)、铜绿假单胞菌(2.7%)和溶血葡萄球菌(2.0%)。大肠埃希菌539株中产ESBLs阳性率为52.5%,肺炎克雷伯菌195株中产ESBLs阳性率为45.2%。大肠埃希菌主要分离于尿液,其次是脓液/切口。肺炎克雷伯菌在痰及咽拭子中所占比例最高。46株铜绿假单胞菌和11株鲍曼复合醋酸钙不动杆菌对亚胺培南耐药。结论对产ESBLs的肺炎克雷伯菌和大肠埃希菌、耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)、耐亚胺培南的鲍曼复合醋酸钙不动杆菌和铜绿假单胞菌,应加强隔离预防,控制在医院内的扩散,减少耐药菌株产生。     

呼吸道产超广谱β-内酰胺酶分离株耐药基因初步分型

目的了解产超广谱β-内酰胺酶 (ESBLs)呼吸道分离株的主要基因型分布特点.方法用表型确证试验确定临床呼吸道标本中产ESBLs的大肠埃希菌和肺炎克雷伯菌.应用聚合酶链反应(PCR)方法扩增产ESBLs株的bla(TEM)、bla(SHV)和bla(CTX-M)基因.结果 PCR结果显示bla(TEM)、bla(SHV)和bla(CTX-M)基因的总阳性率分别为40 .7%、45.7%和75.3%,其中大肠埃希菌分别为:64.9%、2.7%和91.9%,肺炎克雷伯菌分别为:20.5%、81.8%和61.4%.67.6%的大肠埃希菌和95.5%的肺炎克雷伯菌同时携带多个基因.结论深圳市人民医院呼吸道分离的产ESBLs大肠埃希菌的主要基因型为CTX-M,肺炎克雷伯菌主要基因型为SHV.大多数菌株同时携带多个基因.     

IncA/C Plasmid-Mediated Spread of CMY-2 in Multidrug-Resistant Escherichia coli from Food Animals in China

Objectives

To obtain a broad molecular epidemiological characterization of plasmid-mediated AmpC β-lactamase CMY-2 in Escherichia coli isolates from food animals in China.

Methods

A total of 1083 E. coli isolates from feces, viscera, blood, drinking water, and sub-surface soil were examined for the presence of CMY-2 β-lactamases. CMY-2-producing isolates were characterized as follows: the bla _CMY-2 genotype was determined using PCR and sequencing, characterization of the bla _CMY-2 genetic environment, plasmid sizing using S1 nuclease pulsed-field gel electrophoresis (PFGE), PCR-based replicon typing, phylogenetic grouping, XbaI-PFGE, and multi-locus sequence typing (MLST).

Results

All 31 CMY-2 producers were only detected in feces, and presented with multidrug resistant phenotypes. All CMY-2 strains also co-harbored genes conferring resistance to other antimicrobials, including extended spectrum β-lactamases genes (bla _CTX-M-14 or bla _CTX-M-55), plasmid-mediated quinolone resistance determinants (qnr, oqxA, and aac-(6′)-Ib-cr), floR and rmtB. The co-transferring of bla _CMY-2 with qnrS1 and floR (alone and together) was mainly driven by the Inc A/C type plasmid, with sizes of 160 or 200 kb. Gene cassette arrays inserted in the class 1 or class 2 integron were amplified among 12 CMY-2 producers. CMY-2 producers belonged to avirulent groups B1 (n = 12) and A (n = 11), and virulent group D (n = 8). There was a good correlation between phylogenetic groups and sequence types (ST). Twenty-four STs were identified, of which the ST complexes (STC) 101/B1 (n = 6), STC10/A (n = 5), and STC155/B1 (n = 3) were dominant.

Conclusions

CMY-2 is the dominant AmpC β-lactamase in food animals and is associated with a transferable replicon IncA/C plasmid in the STC101, STC10, and STC155 strains.     

社区与医院感染中肺炎克雷伯杆菌和大肠埃希菌耐药性分析

目的探讨社区和医院感染中肺炎克雷伯杆菌和大肠埃希菌产ESBLs的情况及耐药特性。方法采用体外扩散确证试验检测ESBLs,同时用Micro scan wat RA way-40系统全自动细菌鉴定/药敏分析仪及K-B琼脂扩散法进行细菌鉴定和体外药敏试验。结果社区感染标本中分离出肺炎克雷伯杆菌79株,产ESBLs20株,阳性率为25.3%,大肠埃希菌177株,产ESBLs27株,阳性率为15.3%;医院感染标本中分离出肺炎克雷伯杆菌82株,产ES-BLs33株,阳性率为40.2%,大肠埃希菌135株,产ESBLs42株,阳性率为31.1%,社区与医院感染菌株产ESBLs比较差异均有统计学意义(P均<0.05);ESBLs阳性菌株对多种抗生素耐药,其耐药性明显高于ESBLs阴性菌株。结论肺炎克雷伯杆菌和大肠埃希菌产ESBLs菌株在临床分离率较高,医院感染标本要显著高于社区感染标本,并且对多种抗生素具有高度耐药性,产ESBLs菌株耐药性显著高于不产ESBLs菌株,临床上应加强对ESBLs的控制,以防感染流行。     

CMY-39型AmpC酶新基因亚型的序列分析与原核表达

目的对弗劳地枸橼酸杆菌所产CMY-39型AmpC酶新基因亚型进行基因克隆和重组表达。方法以产CMY-39型AmpC酶新基因亚型的弗劳地枸橼酸杆菌总基因组DNA为模板,PCR扩增CMY-39,将其克隆入pGEM-T载体后测定该核苷酸序列,再将CMY-39基因克隆到pET-32 a（＋）系统进行重组,重组菌在大肠埃希菌BL21中表达,SDS-PAGE电泳鉴定酶蛋白的表达。结果 PCR扩增出大小为1 146 bp的基因片段,与GenBank上CMY-39的基因序列同源性为99%。大肠埃希菌BL21转化pET-32 a（＋）/CMY-39重组质粒后,AmpC酶三维试验为阳性。此基因能在大肠埃希菌中大量表达,SDS-PAGE电泳显示,蛋白分子质量大约为60 kD。结论此基因为CMY-39新基因亚型,登陆号为HM565135;成功表达重组的CMY-39型酶,为进一步做酶动力学及酶的其他分子生物学特性研究奠定了基础。     

Behavior of a hybrid F' ts114 lac+, his+ factor (F42-400) in Klebsiella pneumoniae M5a1.

Episome F' ts114 lac+, his+ (F42-400) was transferred from Salmonella typhimurium to Klebsiella pneumoniae. From the progeny, a strain of K. pneumoniae able to retransfer the episome was obtained. The His+ phenotype in this strain is temperature sensitive. Escherichia coli female-specific phages phiII, W31, and T3 were shown to plate on K. pneumoniae. From phiII we obtained two derivatives; phiIIK, which plates only on K. pneumoniae, and phiIIE, which plates only on E. coli. Growth of phages T3 and phiIIK was inhibited by F42-400 in K. pneumoniae. Growth in presence of acridine orange in a defined medium at 40 C resulted in a high level of curing. The frequency of His+ cells after growth in acridine orange at 40 C was 0.001%. An extensive search to detect chromosome mobilization by F42-400 in K. pneumoniae, under different experimental conditions, was negative. We cannot exclude the possibility that the low transfer efficiencies prevented our detection of chromosome mobilization. A search among temperature-resistant, acridine orange-curing-resistant, or galactose-resistant derivatives of the K. pneumoniae donor strain failed to reveal any chromosome transfer. Our failure to detect Hfr's may be a result of: (i) the peculiarity of episome F42-400, (ii) the peculiarity of K. pneumoniae chromosome, or (iii) low transfer efficiency. K. pneumoniae-modified F42-400 and phage 424 were restricted by E. Coli K-12. E. coli K-12-modified episome F42-400 and phage 424 were restricted by K. pneumoniae. E. coli C failed to restrict F42-400 modified with K. pneumoniae specificity. The ability of K. pneumoniae to accept F42-400 is less, by about a factor of 50, than that of E. coli C. As an explanation for the differences in the behavior of E. coli C and K. pneumoniae in ability to receive F42-400 it was suggested that recipient bacteria have specific sites for interaction with the F-pilus tip; these are present in E. Coli C, leading to high transfer efficiency, whereas they may not be present (or if present, are not accessible) in K. pneumoniae, leading to low transfer efficiency.     

Construction of a new Streptococcus pneumoniae-Escherichia coli shuttle vector based on the replicon of an indigenous pneumococcal cryptic plasmid.

The nucleotide sequence of a cryptic plasmid (pRMG1) isolated from a type 1 Streptococcus pneumoniae has been determined and two recombinant plasmids, pRMGE1 and pRMGE2, bearing the pRMG1 replicon have been constructed. pRMGE2 is a shuttle vector for Escherichia coli and S. pneumoniae. The important characteristics of this cloning vector are: a size of 5.5 kb including a 1.4 kb fragment of pRMG1 (containing a double-stranded replication origin and an open reading frame encoding a putative replication initiation protein), a multicloning site, two antibiotic resistance markers for selection of plasmid containing cells, and blue-white colony screening in E. coli for identification of insert-containing plasmids.     

Enterotoxigenicity,klebocinogeny and antibiotic resistance pattern of food isolates ofKlebsiella pneumoniae

The enterotoxigenicity, klebocinogeny and susceptibility to antibiotics for 100 strains of Klebsiella pneumoniae isolated from various food samples is reported. 49% of the samples supported growth of K. pneumoniae: a high proportion of these strains were isolated from sweets and snacks (51%). Enterotoxigenicity as determined by a coagglutination test with anti-LT4 coated staphylococci was observed in 61 of 100 Klebsiella isolates. 21% of the strains were found to be klebocin producers against the K. pneumoniae WC indicator strain. A significant correlation was observed between klebocinogeny and enterotoxigenicity (p less than 0.05). Most strains (91 and 74% respectively) were inhibited by gentamicin and nalidixic acid. Most of the strains were multiply drug-resistant.     

In vitro activity of three different antimicrobial agents against ESBL producing Escherichia coli and Klebsiella pneumoniae blood isolates

Extended spectrum beta-lactamases (ESBLs) usually associated with multiple drug resistance, including beta-lactam and non-beta-lactam antibiotics. This resistance can cause Limitation in the choice of drugs appropriate for using in clinical practice, especially in life-threatening infections. In this study we aimed to investigate in vitro activity of meropenem, ciprofloxacine and amikacin against ESBL-producing and non-producing blood isolates of Escherichia coli and Klebsiella pneumoniae strains. Fifty-eight E. coli (21 ESBL-producing, 37 non-ESBL producing) and 99 K. pneumoniae (54 ESBL-producing, 45 non-ESBL producing) strains were included in the study. The presence of ESBL was investigated by double disk synergy test and E-test methods. Antibiotic susceptibility test was done by microdilution method according to NCCLS guideline. In vitro susceptibilities of ESBL producing E. coli and K. pneumoniae strains were found as 100% for meropenem, 33.3% and 25.9% for ciprofloxacine, 94.5% and 83.3% for amikacin. It was observed that; meropenem was equally active agent in both ESBL-producing and non-producing strains, and its activity was not affected by ESBL production. Whereas amikacin activity was minimally affected and ciprofloxacine activity was markedly decreased by ESBL production. In conclusion, meropenem seems to be better choice of antibiotic should be used for ESBL positive life-threatening infections, because of remaining highest activity.     

重症监护病房产ESBLs菌的基因分型

目的了解深圳市人民医院重症监护病房分离菌超广谱β-内酰胺酶（ESBLs）的检出率及其基因型分布情况。方法收集来自重症监护病房大肠埃希菌和肺炎克雷伯菌分离株48株,采用CLSI推荐的表型确证方法筛选出ESBLs株,并利用PCR及DNA测序法分析产酶菌株的ESBL基因型。结果（1）48分离株菌中共检出产ESBLs菌24株,阳性率为50.0%。（2）产酶菌中93.8%（15/16）的大肠埃希菌和87.5%（7/8）的肺炎克雷伯菌分别检出CTX-M基因;其中72.7%（16/22）为CTX-M-14。6株肺炎克雷伯菌检出SHV基因,其中3株为SHV-11型,另3株为SHV-12型,6株含SHV基因的肺炎克雷伯菌中5株合并CTX-M基因。而所有大肠埃希菌株均未检出SHV基因。所有产酶菌中,分别有10株大肠埃希菌和2株肺炎克雷伯菌检出TEM-1基因,其中1株大肠埃希菌只检出TEM-1基因,未检出SHV型或CTX-M型基因。结论重症监护病房分离菌ESBLs检出率高,以CTX-M-14为主要基因型。     

Truncated forms of PspA that are secreted from Streptococcus pneumoniae and their use in functional studies and cloning of the pspA gene.

Insertion-duplication mutagenesis was used to generate mutants of Streptococcus pneumoniae that produced truncated forms of PspA (pneumococcal surface protein A). The truncated products, representing from 20 to 80% of the complete PspA molecule, were all secreted from the cell and could be detected in unconcentrated culture medium. Analysis of the truncated molecules showed that the antigenic variability known to be associated with PspA is located in the alpha-helical N-terminal half of the molecule. This region was also found to contain immunogenic and protection-eliciting epitopes and to define the maximum region of the molecule that is likely to be surface exposed. The apparent molecular weight variability seen for PspA molecules of different S. pneumoniae strains was localized to both the N- and C-terminal halves of the protein. Attachment of PspA to S. pneumoniae was found to require regions located carboxy to the fifth repeat unit in the C-terminal end of the molecule. From the insertion-duplication mutants, the complete pspA gene was cloned and expressed in Escherichia coli. Differences in apparent molecular weight were observed when the same cloned product was expressed in E. coli and S. pneumoniae, suggesting that PspA is modified differently in the two hosts.     

ASSESSMENT OF IMPEDANCE MICROBIOLOGICAL METHOD FOR THE DETECTION OF ESCHERICHIA COLI IN FOODS

This study was conducted to determine the sensitivity and specificity of the impedance-based microbiological method for the detection of Escherichia coli in foods within 24 h of testing. A Malthus Microbiological Analyzer system (Malthus System V, Malthus Instruments Ltd., Bury, United Kingdom), and a modified Malthus Coliform Broth Medium (MCBM), and an incubation temperature of 44C were used. The sensitivity of the impedance method was determined by testing E. coli-negative food samples spiked with different concentrations of E. coli. The specificity of the method was determined by testing E. coli -negative food samples spiked with Klebsiella pneumoniae, Enterobacter cloacae and Pseudomonas aeruginosa. The test results were compared with those obtained by the Most Probable Number (MPN) method. Milk, milk products, raw and ready-to-eat meats, and vegetables were tested for the presence of E. coli by both methods. The sensitivity of the impedance method and the MPN method for the detection of foods containing 10¹ CFU/g was 100% and 84.4%, respectively. Both methods had a specificity of 100% for food samples spiked with 10¹ CFU/g E. coli. The specificity of the impedance and the MPN methods for the detection of E. coli in naturally contaminated milk and meat samples was 100% and 95.7% respectively. E. coli was detected in foods by the impedance method within 4–24 h of testing at a detection limit of 1 CFU/mL. These results demonstrate that the impedance method can be used as a rapid and sensitive method for the detection of E. coli in foods.     

深圳地区产超广谱β-内酰胺酶菌株的TEM基因分析

目的了解本地区临床分离的产超广谱β-内酰胺酶(ESBLs)株携带TEM基因的情况.方法应用表型确证试验筛选产ESBLs大肠埃希菌和肺炎克雷伯菌.碱裂解法提取产酶株的质粒,应用PCR方法分析TEM基因.结果215株产ESBLs菌株中TEM基因阳性87株,阳性率为40.5%,其中产酶大肠埃希菌TEM阳性率为49.7%,肺炎克雷伯菌阳性率为18.8%.TEM型产酶株主要来源于痰和尿标本(37.9%和22.0%),在肝胆外科、重症监护室和老年病科分布较多.结论TEM型为本地区产ESBLs大肠埃希菌和肺炎克雷伯菌常见的基因型,广泛分布于各临床科室,需引起重视.     

某院感染科病房住院患者常见病原菌分布及 耐药性分析

目的对感染科病房住院患者临床常见病原菌的分布及其耐药性进行分析,为临床预防和治疗感染性疾病提供依据。方法回顾性分析中国医科大学附属第一医院感染科病房2012年1月至2016年12月从住院患者体液及组织样本中分离的病原菌,对其耐药情况进行分析。结果 5年中感染科共分离出非重复病原菌1 266株,其中革兰阴性菌786株,占62.09%,分离率居前3位的是大肠埃希菌、肺炎克雷伯菌以及铜绿假单胞菌,分别占17.22%、15.24%和10.58%;革兰阳性菌共480株,占37.91%,分离率居前3位的是屎肠球菌、草绿色链球菌以及金黄色葡萄球菌,分别占9.79%、7.50%和6.00%。产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌检出率分别为66.7%和28.8%。大肠埃希菌对亚胺培南和美罗培南的耐药率分别为0.95%和3.79%,肺炎克雷伯菌对亚胺培南和美罗培南的耐药率分别为2.80%和2.80%。结论我院感染科病房住院患者感染病原菌以革兰阴性菌为主,为有效地控制和避免耐药菌感染的发生,临床应根据药敏试验结果合理应用抗菌药物。