耐碳青霉烯类肺炎克雷伯菌所致的呼吸机相关性肺炎的流行病学及耐药性分析

发布时间：2018-05-29 22:23

本文选题：重症医学科 + 耐碳青霉烯类抗菌药物　；参考：《中华医院感染学杂志》2017年04期

【摘要】：目的分析重症医学科临床分离的耐碳青霉烯类肺炎克雷伯菌(CRKP)所致的呼吸机相关性肺炎(VAP)的流行病学及耐药性,为临床治疗提供依据。方法选取2014年3月-2016年9月医院重症医学科收治的肺炎克雷伯菌感染患者80例,另选取同期分离株对碳青霉烯类抗菌药物敏感的肺炎克雷伯菌(CSKP)感染患者为对照组,对其临床资料进行回顾性分析,并测定肺炎克雷伯菌对常用抗菌药物敏感性。结果通过对CRKP与CSKP的VAP患者临床资料进行比较,发现入住重症医学科时间、机械通气时间、使用抗菌药物种类及时间两组间比较差异有统计学意义(P0.05);经对CRKP药物敏感性测定,CRKP对亚胺培南、头孢他啶、头孢曲松、氨曲南、哌拉西林、左氧氟沙星、头孢哌酮/舒巴坦、环丙沙星及磺胺甲VA唑/甲氧苄啶等耐药性较高,对替加环素、阿米卡星、庆大霉素的敏感性较高。结论重症医学科临床分离CRKP所致呼吸机感染受多种因素影响,主要对亚胺培南、头孢他啶、头孢曲松等药物具有较高耐药性,为有效控制感染的发生,临床上应根据药敏试验结果进行合理用药。
[Abstract]:Objective to analyze the epidemiology and drug resistance of ventilator associated pneumonia (VAPs) caused by Klebsiella carpenicilli (CRKP) isolated from the Department of intensive Medicine, so as to provide evidence for clinical treatment. Methods from March 2014 to September 2016, 80 patients with Klebsiella pneumoniae infection were selected as control group. The clinical data and susceptibility of Klebsiella pneumoniae to common antimicrobial agents were analyzed retrospectively. Results by comparing the clinical data of VAP patients with CRKP and CSKP, we found that the time of staying in intensive care department and the time of mechanical ventilation were found. There were significant differences in the types and time of antibiotics used between the two groups (P 0.05). The sensitivity of CRKP to imipenem, ceftazidime, ceftriaxone, aztreonam, piperacillin, levofloxacin, cefoperazone / sulbactam was determined. The drug resistance of ciprofloxacin and sulfamethazol / trimethoprim was higher, and the sensitivity of ciprofloxacin, amikacin and gentamicin was higher. Conclusion the ventilator infection caused by clinical isolation of CRKP in the department of intensive medicine is affected by many factors, and it has high drug resistance to imipenem, ceftazidime and ceftriaxone. The rational use of drugs should be carried out according to the results of drug sensitivity test in clinic.
【作者单位】：温岭市第一人民医院重症医学科;浙江省人民医院重症医学科;
【基金】：浙江省中医药科学研究基金计划(A类)(2010ZA103)
【分类号】：R563.1

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