| 丁正清,刘洪道.碳青霉烯耐药肺炎克雷伯菌感染51例分析[J].安徽医药,2018,22(10):2031-2033. |
| 碳青霉烯耐药肺炎克雷伯菌感染51例分析 |
| Analysis of 51 cases of carbapenem-resistant Klebsiella pneumonia infection |
| 投稿时间：2017-02-22 |
| DOI： |
| 中文关键词: 肺炎克雷伯菌 β内酰胺抗药性 纸片扩散抗菌试验 呼吸,人工 危险因素 |
| 英文关键词: Klebsiella pneumoniae beta-Lactam resistance Disk diffusion antimicrobial tests Respiration,artificial Risk factors |
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| 中文摘要: |
| 目的 研究碳青霉烯耐药肺炎克雷伯菌(Carbapenem-resistant Klebsiella pneumonia,CRKP)致使患者感染的临床特征及耐药性,为临床治疗方案的选择提供参考依据。 方法 收集从2011年至2015年于淮安市淮安医院住院治疗患者51株非重复CRKP,对其进行临床特征分析、抗菌药物药敏试验,分析耐药性情况及导致感染的危险因素。 结果 按照占比从高到低顺序排列,菌株来源病区分别为重症监护室、感染科、呼吸内科、胸心外科、神经内科以及血液科；菌株来源标本类型按照占比从高到低顺序排列,分别是痰液、尿液、血液、胆汁及创面、脓液；头孢菌素类、青霉素类以及美罗培南和环丙沙星耐药率高达100.00%(51/51),其余抗菌药物按照耐药率高低顺序分别为左旋氧氟沙星、头孢呋辛、庆大霉素、四环素、复方磺胺甲唑、氨曲南、妥布霉素等。碳青霉烯耐药同时合并产生广谱β-内酰胺酶(ESBLs) 11株。根据logistic回归分析法评价可知,入住ICU、住院时间≥7 d、机械通气时间≥5 d、合并糖尿病以及多种抗生素联用均为影响患者感染的危险因素。 结论 CRKP具有严重的多重耐药情况,其耐药性可能与呼吸机使用及产ESBLs存在一定的相关性。 |
| 英文摘要: |
| Objective To study the clinical features and drug resistance of carbapenem-resistant Klebsiella pneumonia (CRKP) infection patients,and to provide reference for the choice of clinical treatment plan. Methods Fifty-one strains of CRKP were collected in Huai′an Hospital of Huai′an from 2011 to 2015.The clinical feature was analyzed,antimicrobial susceptibility test was conducted,and drug resistance,and risk factors of infection were analyzed. Results According to the order of proportion from high to low sequence,the source areas of the strains were intensive care unit,infection department,respiratory department of internal medicine,department of thoracic and cardiac surgery,department of neurology and department of hematology;the sources of strain type specimens according to the order of proportion from high to low sequence were sputum,urine,blood,bile and wound infection,and pus specimens;the resistance rates of cephalosporins,penicillins,meropenem and ciprofloxacin were up to 100% (51/51) and other antibacterial drugs according to the order of the resistance rates from high to low sequence were levofloxacin,cefuroxime,gentamicin,tetracycline,cotrimoxazole,aztreonam and tobramycin.Eleven strains of ESBLs were simultaneously produced with the resistance to carbapenem.The logistic regression analysis showed that ICU stay,hospitalization time ≥7 days,mechanical ventilation time ≥5 days,diabetes mellitus and combined use of antibiotics were risk factors of infection in patients. Conclusions CRKP has severe multi-drug resistance,and the mechanism of drug resistance may be related to the use of ventilator and production of ESBLs. |
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