急诊重症监护室患者感染碳青霉烯类耐药肺炎克雷伯菌分子流行病学的研究

发布时间：2018-03-18 06:13

本文选题：碳青霉烯耐药肺炎克雷伯菌　切入点：流行病学　出处：《中华医院感染学杂志》2017年15期 　论文类型：期刊论文

【摘要】：目的对急诊科重症监护室患者分离出的碳青霉烯类耐药肺炎克雷伯菌(CR-KPN)进行流行病学调查,为临床治疗提供参考依据。方法选取2015年12月-2016年5月北京大学第一医院急诊科重症监护室(EICU)14例患者的呼吸道分泌物及尿、脓标本,对分离到的CR-KPN进行纸片法抗菌药物敏感试验,并通过脉冲场凝胶电泳(PFGE)DNA指纹图技术对菌株进行比对,确定菌株的同源性,同时结合临床资料进行分析。结果共分离出15株CR-KPN分别来自不同克隆,提示为特定位置的特定菌株簇,应为散发感染或定植菌株,或输入性CR-KPN感染;分离出15株CR-KPN的14例患者中,6例感染CR-KPN的患者死亡。结论 CR-KPN感染多见于危重症患者,在急诊ICU多为散发病例,治疗困难,死亡风险高。
[Abstract]:Objective to investigate the epidemiology of Klebsiella pneumoniae resistant Klebsiella pneumoniae isolated from intensive care unit of emergency department. Methods from December 2015 to May 2016, 14 cases of respiratory secretions, urine and pus were collected from the intensive care unit of Emergency Department, first Hospital of Peking University. The paper method was used to test the susceptibility of the isolated CR-KPN to antimicrobial agents. The homology of the strains was determined by comparing the strains with pulsed field gel electrophoresis (PGE) DNA fingerprinting technique. Combined with clinical data, 15 strains of CR-KPN were isolated from different clones, suggesting that specific strains with specific location should be sporadic or colonized, or imported CR-KPN infection. Among the 14 patients with CR-KPN, 6 died of CR-KPN. Conclusion CR-KPN infection is more common in critically ill patients and sporadic cases in emergency ICU patients, which is difficult to treat and has a high risk of death.
【作者单位】：北京大学第一医院急诊科;北京大学第一医院北京大学临床药理研究所;北京大学第一医院检验科;
【分类号】：R446.5

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