| 摘要: |
| ［摘要］目的 了解昆明医科大学第一附属医院耐碳青霉烯类弗氏柠檬酸杆菌的分布及药敏情况，指导临床合理用药．方法 收集2012年1月至2014年12月临床送检标本中分离到的弗氏柠檬酸杆菌，通过VITEK-2系统测定抗菌药物的最低抑菌浓度（MIC），分析碳青霉烯类耐药的弗氏柠檬酸杆菌的耐药特点．结果（1）分离的21株耐碳青霉烯类弗氏柠檬酸杆菌中，主要标本来源为尿液（95%），科室分布以移植中心（66.7%）和泌尿外（19%）为主；（2）药敏结果显示待测菌株对头孢菌素类及其酶抑制剂均高度耐药，甚至对碳青霉烯类抗生素也高度耐药,其中亚胺培南耐药率为90%（95%CI:70～99），美罗培南耐药率为85.7%（95%CI:64～97），以阿米卡星耐药率最低（4.8%），其次为呋喃妥因（10.5%）和磷霉素（15%）．结论 昆明医科大学第一附属医院耐碳青霉烯类的弗氏柠檬酸杆菌引起的感染以泌尿道感染多见，且多重耐药为其显著特点，应加强耐药监测，指导临床规范用药，控制耐药株的流行． |
| 关键词: ［关键词］耐碳青霉烯类弗氏柠檬酸杆菌 细菌分布 耐药性 |
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| 基金项目:［基金项目］云南省科技厅-昆明医科大学联合专项基金资助项目（2012FB040）；昆明医科大学硕士创新基金项目（2015S19） |
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| Distribution and Drug Resistance of Carbapenem-resistant Citrobacter Freundii from 2012 to 2014 |
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LIU Shu－min1,2
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1.（1）The 1st Affiliated Hospital of Kunming Medical University，Research Institution of Laboratory Diagnostic in Yunnan Province，Kunming，Yunnan Province 650032;2.２）Yan’an Hospital Affiliated to Kunming Medical University，Kunming，Yunnan Province 650051，China）
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| Abstract: |
| ［Abstract］Objective To investigate the distribution and susceptibility of carbapenem resistant citrobacter freundii for rational antimicrobial therapy. Methods The C.freumdii were collected between January 2011 and December 2014 from inpatients. The minimum inhibitory concentration（MIC） were detected by an automated analyzer（VITEK 2）to analyze the characteristic of tested bacteria. Results（1）Of the 21 strains of carbapenem-resistant citrobacter freundii，95% were collected from urine， among which most of the strains were isolated from the Department of Transplantology（66.7%）and Urology（19%）；（2）Antimicrobials Susceptibility test showed that Citmbacter freund were highly resistant to Cephalosporins and relevant beta -lactamase inhibitors．Even carbapenem were highly resistant.Imipenem had a resistance rate of 90%（95% confidence interval :70 to 99），Meropenem 85.7%（95% confidence interval:64 to 97），The drug resistance rate to Amikacin was only 4.8%，followed by Nitrofuran toin（10.5%）and Fosfomycin（15%）. Conclusions Carbapenem resistant citrobacter freundii，which often causes urinary tract infection in our hospital，was characterized by multi-drug resistant （MDR）. Monitoring of the Citrobaeter freundii should be strengthened to control the prevalence of drug resistance. |
| Key words: ［Key words］Carbapenem-resistant citrobacter freundii Bacterial distribution Drug resistance |