烧伤患者感染耐碳青霉烯类肺炎克雷伯菌耐药趋势与抗菌药物使用分析

发布时间：2018-12-09 13:28

【摘要】：目的分析烧伤患者临床分离出的耐碳青霉烯类肺炎克雷伯菌(CRKP)耐药趋势及其耐药性,为烧伤感染患者临床合理用药提供依据。方法选2010年1月-2015年1月烧伤科收治的1 816例烧伤患者,共分离出耐碳青霉烯类抗菌药物肺炎克雷伯菌(CRKP)268株,分别采用美国碧迪Phoenix 100全自动细菌鉴定分析仪及KB纸片(扩散)法,测定菌株的药物敏感性,数据采用WHONET 5.6软件进行统计分析。结果 5年烧伤患者临床分离出CRKP 268株,检出率为14.8%;CRKP对氨曲南、头孢哌酮/舒巴坦、氨苄西林、头孢他啶、左氧氟沙星、庆大霉素及亚胺培南、美罗培南、厄他培南的耐药性逐年上升且与年份增加呈正相关(P0.05),碳青霉烯类抗菌药物(亚胺培南、美罗培南)使用强度与CRKP检出率呈正相关(P0.05)。结论烧伤创面CRKP检出率居烧伤病房首位,应加强烧伤创面处理以控制CRKP的播散。
[Abstract]:Objective to analyze the trend of (CRKP) resistance and drug resistance of Klebsiella pneumoniae isolated from burn patients. Methods from January 2010 to January 2015, 1 816 burn patients were treated in the Department of Burns. A total of 268 strains of Klebsiella pneumoniae resistant to carbapenem antibiotics were isolated. The drug sensitivity of the strain was determined by Phoenix 100 automatic bacterial identification analyzer and KB disk (diffusion) method. The data were analyzed by WHONET 5.6 software. Results 268 strains of CRKP were isolated from burn patients in 5 years and the detection rate was 14.8%. The drug resistance of CRKP to aztreonam, cefoperazone / sulbactam, ampicillin, ceftazidime, levofloxacin, gentamicin, imipenem, meropenem and ertopenem increased year by year and was positively correlated with the increase of year (P0.05). The intensity of carbapenem antibiotics (imipenem, meropenem) was positively correlated with the detection rate of CRKP (P0.05). Conclusion the detection rate of CRKP in burn wound is the first in burn ward. The treatment of burn wound should be strengthened to control the spread of CRKP.
【作者单位】：十堰市太和医院湖北医药学院附属医院烧伤整形科;上海交通大学医学院附属瑞金医院烧伤整形科;
【基金】：国家自然科学基金资助项目(81272112) 上海交通大学医学院科技基础基金资助项目(YZ1007)
【分类号】：R644;R446.5

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