2011-2016年耐碳青霉烯肺炎克雷伯菌医院感染趋势分析  

Tendency analysis of carbapenem-resistant Klebsiella pneumoniae nosocomial infections from 2011 to 2016

作　　者：姚希[1] 徐丹慧[1] 贾建侠[1] 赵艳春[1] 任军红[1] 贾会学[1] 赵秀莉[1] 李六亿[1] YAO Xi XU Dan-hui JIA Jian-xia ZHAO Yan-chun REN Jun-hong JIA Hui-xue ZHAO Xiu-li LI Liu-yi(Peking University First Hospital, Beijing 100034, China)

机构地区：[1]北京大学第一医院感染管理-疾病预防控制处,北京100034

出　　处：《中华医院感染学杂志》2017年第12期2652-2655,共4页Chinese Journal of Nosocomiology

摘　　要：目的通过耐碳青霉烯类肺炎克雷伯菌(CRKP)医院感染的趋势,了解医院CRKP感染特点与变化,为CRKP医院感染预防控制提供依据。方法前瞻性调查2011年1月-2016年12月入住某三甲综合医院患者429 933例,采用统一调查方法收集临床微生物检验1 208株肺炎克雷伯菌阳性的患者病历资料,并判定菌株的感染、定植与污染,分析CRKP检出率和感染率变化趋势。结果 2011年1月-2016年12月1131例次患者检出肺炎克雷伯菌,其中162例次患者检出CRKP,CRKP总检出率为14.32%,其各年份检出率总体上升,差异有统计学意义(P<0.01);成人ICU的检出率最高,为28.94%,上升也最为明显,从2011年的2.13%上升至2016年的48.57%;162例次患者CRKP中定植59例次,占36.42%,社区感染54例次,占33.33%,医院感染49例次,占30.24%;社区感染率从2011年的0.04‰上升至2016年的0.23‰,医院感染万日感染率也从0.13上升为0.27,社区感染上升幅度更大。结论 CRKP的感染率呈现逐年上升趋势,其中社区感染和定植例次上升更为明显,提高了CRKP医院感染的预防控制难度。OBJECTIVE To understand the characteristics and tendency of carbapenem resistant Klebsiella pneumoniae （CRKP） infections in a tertiary general hospital by analysis of the tendency of CRKP nosocomial infection,so as to provide evidence for prevention and control of CRKP nosocomial infections.METHODS A prospective study of 429933 patients admitted toa3 tertiary general hospital from Jan.2011 toDec.2016 was conducted.The patients who were positive for 1208 strains of K.pneumonia were followed by a unified survey to collectclinical data,and to determine the infections,colonization and contamination.CRKP detection rate and infection rate trendency was analyzed.RESULTS Totally 1131 cases of K.pneumoniae were detected from 2011 to 2016,162 of them were CRKP.The total detection rate of CRKP was 14.32%.the detection rate of each year was increased significantly （P〈0.01）.The detection rate of adult intensive care unit was the highest,which was 28.94%,and the rise was also the most obvious,which was from 2.13% in 2011 to 48.57% in 2016.Among the 162 cases,59 cases were colonized （36.42%）,54 cases （33.33%） were community infections,and 49 cases （30.24%） were hospital infections.The infection rate of community infections was increased from 0.04‰ in 2011 to 0.23‰.in 2016,and the ten-thousand day infection rate of nosocomial infections was increased from 0.13 to 0.27.Community infection rate increased even more.CONCLUSION The infection rate of CRKP is increased year by year,among which community infections and colonization are more obvious,which increase the difficulty of prevention and control of CRKP nosocomial infections.

关 键 词：耐碳青霉烯肺炎克雷伯菌 医院感染 综合医院 

分 类 号：R378.996[医药卫生—病原生物学]