耐碳青霉烯类肺炎克雷伯菌医院感染流行特征分析

发布时间：2018-05-29 11:58

本文选题：肺炎克雷伯菌 + 耐碳青酶烯类　；参考：《中华医院感染学杂志》2016年21期

【摘要】：目的分析耐碳青霉烯类肺炎克雷伯菌医院流行特征,为临床治疗提供依据。方法收集2013-2015年医院各临床科室患者临床标本分离的肺炎克雷伯菌株2 941株,对肺炎克雷伯菌医院感染的流行特征进行回顾性分析。结果 2013-2015年共分离肺炎克雷伯菌株2941株,其中耐碳青霉烯类菌株358株,2013-2015年碳青霉烯耐药率分别为3.79%、14.43%、14.53%,呈逐年上升趋势;碳青霉烯耐药菌株主要来源于痰(34.08%)、组织(16.76%)、尿(14.25%)、血液(11.17%)等标本;2013年度仅在部分科室散发,2014-2015年在肝胆外科病区、外科监护室、呼吸科监护室、神经内科监护室、呼吸科病区耐碳青霉烯类肺炎克雷伯菌持续存在,在其他科室多为散发;耐碳青霉烯类肺炎克雷伯菌对除阿米卡星、庆大霉素、磺胺甲VA唑/甲氧苄啶外的大多数抗菌药物表现高度耐药性,耐药率85%;碳青霉烯敏感的肺炎克雷伯菌对除氨苄西林外的其他抗菌药物均保持较好的敏感性,敏感率75%。结论肺炎克雷伯菌碳青霉烯类耐药问题表现日益严峻,合理应用抗菌药物等措施对有效地控制耐碳青霉烯类肺炎克雷伯菌医院感染暴发流行至关重要。
[Abstract]:Objective to analyze the epidemic characteristics of Klebsiella pneumoniae resistant to carbapenem in hospitals and provide evidence for clinical treatment. Methods A total of 2941 strains of Klebsiella pneumoniae were collected from clinical specimens from clinical departments in our hospital from 2013 to 2015. The epidemic characteristics of nosocomial infection of Klebsiella pneumoniae were analyzed retrospectively. Results A total of 2941 Klebsiella pneumoniae strains were isolated from 2013 to 2015. The resistance rates of carbapenem resistant strains to carbapenem in 2013-2015 were 3.79 and 14.43 respectively, showing an increasing trend year by year. The carbapenem resistant strains mainly come from sputum 34.08, tissue 16.7667, urine 14.2525, blood 11.17) and so on. In 2013, they were only distributed in some departments in 2014-2015 in hepatobiliary surgery ward, surgical intensive care unit, respiratory intensive care unit, neurology unit, and so on. Klebsiella pneumoniae resistance to carbapenem in respiratory ward is persistent, most of them are sporadic in other departments, and resistant to Klebsiella pneumoniae is resistant to amikacin, gentamicin, and gentamicin. Most antimicrobial agents of sulfamethoxazole / trimethoprim showed high drug resistance (85%), and carbapene-sensitive Klebsiella pneumoniae maintained good sensitivity to other antimicrobial agents except ampicillin (75%). Conclusion the problem of carbapenem resistance of Klebsiella pneumoniae is becoming more and more serious. The rational use of antimicrobial agents is very important to effectively control the outbreak of nosocomial infection of Klebsiella pneumoniae.
【作者单位】：解放军总医院微生物科;
【基金】：国家传染病重大专项基金资助项目(2013ZX10004217002002)
【分类号】：R446.5

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