目的 探究及分析某医院内科重症监护病房（ICU）住院患者耐碳青霉烯肠杆菌（CRE）定植情况及耐药情况，为重症监护室感控管理提供指导依据。方法 对 2017 年 3 月至 2018 年 12 月某内科 ICU 新入院 394 例患者进行肛拭子 CRE 主动筛查 760 份标本，进行病原菌分离鉴定和抗菌药物敏感试验检测。结果 病原菌分离鉴定为肛拭子筛查 CRE 阳性标本 84 份，肛拭子筛查 CRE 阳性率 11.05%（84/760）， 检出 CRE 101 株，总检出率为 15.63%（101/646）。其中耐碳青霉烯肺炎克雷伯菌的检出率最高为 43.18% （76/176）；其次为弗氏柠檬酸杆菌 21.43%（3/14）；阴沟肠杆菌 20.00%（2/10）；产气肠杆菌 16.67%（1/6）；大 肠埃希菌 4.79%（18/376）；奇异变形杆菌 2.33%（1/43）。抗菌药物敏感试验检测出不同碳青霉烯药物耐药 率不同：厄他培南的耐药率最高为 99.01%；亚胺培南耐药率为 81.19%；美罗培南耐药率为 80.20%。肛拭子 CER 阳性率和 CRE 检出率较部分文献差异有统计学意义（P < 0.05）。结论 本研究主动筛查 CRE 定植 阳性较高，厄他培南、亚胺培南和美罗培南三种药物耐药率高，对加强 CRE 的集束化管理，防止 CRE 在院内发生感染提供参考依据。

Objective To explore and analyze the colonization and drug resistance of carbapenem⁃resistant enterobacter（CRE）in patients in internal medicine ICUand to provide guidance for infection control management in ICU. Methods Active anal swab screening for CRE was performed in 394 newly admitted patients in internal medicine ICUfrom March 2017 to December 2018. The isolation and identification of pathogenic bacteria and anti⁃ microbial sensitivity testwere performed in 760 samples. Results Eighty ⁃four positive specimens were detected from 760 samples with a positive rate of 11.05%（84/760）. Furthermore，101 strains of CRE were detected with a total detection rate of 15.63%（101/646）. The detection rate of carbapenem⁃resistant Klebsiellapneumoniae was the highest，accounting for 43.18%（76/176）；followed by Citrobacterfreundii，21.43%（3/14），Enterobacter cloacae， 20.00%（2/10）；Enterobacter aerogenes，16.67%（1/6），Escherichia coli，4.79%（18/376），Proteus mirabilis 2.33%（1/43）. Antimicrobial sensitivity test showed that the drug resistance rate of different carbapenems was varied as follows：etapenem（99.01%），imipenem（81.19%）and meropenem（80.20%）. Conclusion There is high positive value of CRE in active screening，and high drug resistance rate of ertapenem，imipenem and meropenemin ICU of department of internal medicine. Therefore，cluster management of CRE is needed to prevent the outbreak of CRE and provide reference for preventing infection of CRE in hospital.