肺炎克雷伯菌的分布及传播途径连续调查  

Continuous investigation on the distribution and transmission routes of Klebsiella pneumoniae

作　　者：王贺永[1] 吴丽丽[2] 张倩 元小冬[3] 陶丽[3] WANG He-yong;WU Li-li;ZHANG Qian;YUAN Xiao-dong;TAO Li(Kailuan General Hospital Laboratory,Tangshan 063000,China;Xie He Hospital Laboratory,Tangshan 063000,China;Kailuan General Hospital Neurology,Tangshan 063000,China)

机构地区：[1]开滦总医院检验科,唐山063000 [2]唐山市协和医院检验科,唐山063000 [3]开滦总医院神经内科,唐山063000

出　　处：《中国人兽共患病学报》2019年第7期610-612,625,共4页Chinese Journal of Zoonoses

基　　金：河北省医学科学研究重点课题(No.20150039)~~

摘　　要：目的连续观察开滦总医院2011—2016年临床分离肺炎克雷伯菌(Klebsiella pneumoniae,KPN)的分布与耐药性变化情况,回顾医院感染防治的长期效果。方法用VITEK2-compact全自动微生物鉴定仪(法国生物梅里埃公司)进行细菌鉴定与药敏实验,用改良Hodges试验筛选产碳青霉烯霉肺炎克雷伯菌(Klebsiella pneumoniae carbapenemases,KPC)菌株。结果6年中共分离出非重复KPN2155株,产超广谱β-内酰胺酶(extended-spectrum beta lactamase,ESBLs)菌有715株,碳青霉烯类耐药肠杆菌科细菌(Carbapenem-resistant Enterobacteriaceae,CRE)有128株,并在2014年有小规模暴发流行。结论KPN易在年老体衰与自身免疫力低下的患者体内引起感染,直接接触传播仍是当前最重要的院内感染传播方式,严格的院内感染防治措施可以有效减缓KPN感染的发展趋势。To investigate the distribution and drug resistance of Klebsiella pneumoniae (KPN) isolated from Kailuan General hospital from 2011 to 2016,and review the long-term effect of prevention and control for nosocomial infection. Autimicrobial susceptibility testing was carried out according to unified protocol using automated system. ESBLs and KPC were detected according to CLSI 2016 M100-S26. Results showed that a total of 2 155 strains of Klebsiella pneumoniae were collected in the past 6 years, of which ESBLs(+) and CRE bacteria accounted for 715 strains and 128 strains. There was a small outbreak in 2014. It is indicated that KPN is easy to cause infection in elderly, frail and immunocompromised patients. Direct contacted spread is still the most important ways of nosocomial infection. Strict nosocomial infection prevention and treatment measures could effectively slow down the development trend of KPN infection.

关 键 词：肺炎克雷伯菌 耐药性 医院感染 

分 类 号：R382.5[医药卫生—医学寄生虫学]