少见耐碳青霉烯类肠杆菌目细菌药敏表型与产碳青霉烯酶酶型的分析

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【关键词】耐碳青霉烯类肠杆菌目细菌;耐药性;碳青霉烯酶;基因型;药敏表型 中图分类号：R446.5 文献标志码：A DOI： 10.3969/j .issn.1003-1383.2025.10.010

Analysis of drug sensitivity phenotypes and carbapenem-producing enzyme types of rare carbapenem-resistant Enterobacterales

QINLan，LUO Guolan，LI Mengwei （， ，Liuzhou545OoO，，）

【Abstract】ObjectiveToanalyze the isolationdistribution，drug resistancecharacteristics，and carbapenemase types of rarecarbapenem-resistant Enterobacterales（CRE），and toprovidelaboratoryevidenceforprecision clinical medication.

MethodsA total of 32 non-repetitiverareCREstrains were collected from clinicalspecimens ina hospital fromOctober 2019 to December 2O24.Drug susceptibility testing was performedusing the VITEK2.Susceptibility to ceftazidime/avibactam（CZA）was determined by Kirby-Bauer（K-B）method and broth microdilution method（BMD）.Carbapenemase phenotypes weredetected by modified carbapenem inactivation method（mCIM/eCIM）and carbapenemase inhibitor enhancement test，while genotypes were detected bycoloidal gold immunochromatography.ResultsAmong the 32rare CRE strains， Enterobacter cloacae accounted for 46. 8 % （15/32），Citrobacter spp. for 18 .8%（6/32） ，and Klebsiella aerogenes for 12.5% （204 （4/3），and therest included Klebsiella oxytoca，Morganella morganii，Serratia marcescens，andProteusmirabilis. Carbapenemase genotypes were predominantly NDM type （ 81.3% ，26/32），followed by KPC type（ 9.4% ， 3/32 ）；phenotypes were mainly metallenzymes （84.4%， 27/32），with a genotype-phenotype consistency rate of 93.8%（30/32） . Drug susceptibility results showed O resistance rate to tigecycline， 12.5% to amikacin，and over 68. 0% to other antimicrobial agents.ConclusionThedrug resistance situationofrare CREinthis hospitalissevere，with NDM-typemetalloenzymesas the maincarbapenemase.Tigecyclineandamikacinareefectivetherapeuticoptions，andlaboratoriesshould strengthen carbapenemase detection to guideprecision clinical medication.

【Keywords】carbapenem-resistant Enterobacterales（CRE）；drug resistance；carbapenemase；genotype；drug susceptibility phenotype

随着美罗培南、亚胺培南和厄他培南等碳青霉烯类抗生素在临床上的广泛应用，耐碳青霉烯类肠杆菌目细菌（carbapenem-resistant Enterobacterales，CRE）的检出率迅速上升[]，这为抗感染治疗带来了新的挑战。（剩余6230字）