CRE与CRAB的比较-Hangzhou

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1、CRE与CRAB的比较王明贵复旦大学华山医院抗生素研究所1主题词：CRE与CRABCRECarbapenem-resistantEnterobaceteriacae碳青霉烯类耐药肠杆菌科细菌CRABCarbapenem-resistantAcinetobacterbaumannii碳青霉烯类耐药鲍曼不动杆菌2CRE与CRAB临床危害最为严重的2个革兰阴性菌3OUTLINE克雷伯菌属与不动杆菌属的分离率变迁CRE与CRAB检出率的比较CRE与CRAB预后的比较CRE与CRAB抗菌治疗的比较4临床分离菌中革兰阴性菌比例高革兰阳

2、性菌：革兰阴性菌≈三七开CHINET2005-20158071.671.571.97372.669.57166.968.27070.265.760504033.134.329.83031.830.52928.428.528.12727.420100200520062007200820092010201120122013201420155临床分离菌TOP10克雷伯菌属与不动杆菌属为Top2&325CHINET201519.520检出1514.1率%10.79.38.9108.74.64.54.253.202012-中国CHINET资料汇

3、总革兰阴性菌TOP6（占所有GNB86%）CHINET2005-2015353028.428.8大肠埃希菌检27.626.927.327.227.826.626.525.925.8出25率%2017.918.118.2肺炎克雷伯菌16.51514.714.714.4151514.61413.613.613.914.214.2鲍曼不动杆菌13.213.412.812.411.5铜绿假单胞菌11.1105阴沟肠杆菌嗜麦芽窄食单胞菌020052006200720082009201020112012201320142015HuFP,ClinM

4、icrobiolInfect2016;22:S9–S14肺炎克雷伯菌与鲍曼不动杆菌的分离率CHINET2005-2015191818.118.217.9肺炎克雷伯菌检17出16.516率%15151514.714.714.614.4鲍曼不动杆菌14.214.2141413.913.613.613.413.21312.812.41211.51111.11020052006200720082009201020112012201320142015HuFP,ClinMicrobiolInfect2016;22:S9–S14Corelation

5、ofincreasingtrendsofimipenem-resistancewithconstituentratioofA.baumanniiclinicalisolatesinChinasince200513Imipenem-resistancerate70CHINETDATA1260RatioCR%1150%Constituentratio104093087206109ModifiedfromHuFP,ClinMicrobiolInfect2016;22:S9–S14Corelationofincreasingtrendsofi

6、mipenem-resistancewithconstituentratioofK.pneumoniaeclinicalisolatesinChinasince2005151814CHINETDATA16ConstituentratioRatio1314CR%12%12111010Imipenem-resistancerate896874625010ModifiedfromHuFP,ClinMicrobiolInfect2016;22:S9–S14OUTLINE克雷伯菌属与不动杆菌属的分离率变迁CRE与CRAB检出率的比较CRE

7、与CRAB预后的比较CRE与CRAB抗菌治疗的比较11总体耐药性最高的革兰阴性菌—不动杆菌属不动杆菌属对多数抗菌药的耐药率>50%不动杆菌属(鲍曼不动93.4%)对抗菌药的耐药率（n=9503）CHINET20158074.870.568.57066.266.664.56260.858.76049.15045.842.84038.1耐药率（％）30209.7100.20B唑噁舒巴坦舒巴坦//替加环素米诺环素阿米卡星庆大霉素他唑巴坦/亚胺培南环丙沙星头孢吡肟头孢他啶美罗培南哌拉西林多黏菌素头孢哌酮复方磺胺甲氨苄西林哌拉西林Pan-dr

8、ugresistance(PDR)inA.baumanniiandP.aeruginosa(colistinandtigecyclinenotincludedforAST)CHINETDATA25P.aeruginosa