肺炎克雷伯菌的临床分布特征及耐药性分析  

Clinical distribution characteristics and drug resistance analysis of Klebsiella pneumoniae

作　　者：卢峰[1] 卜素[1] 张昌峰[1] 张士杰 霍星星[2] LU Feng;BU Su;ZHANG Chang-feng;ZHANG Shi-jie;HUO Xing-xing(Laboratory Center,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei,Anhui 230031,China;Experimental Center of Clinical Research,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei,Anhui 230031,China)

机构地区：[1]安徽中医药大学第一附属医院检验中心,安徽合肥230031 [2]安徽中医药大学第一附属医院临床研究实验中心,安徽合肥230031

出　　处：《临床肺科杂志》2020年第9期1329-1332,共4页Journal of Clinical Pulmonary Medicine

基　　金：安徽省自然科学基金(No.1908085QC90)。

摘　　要：目的探讨肺炎克雷伯菌(Klebsiellapneumoniae,K.pneumoniae)的临床分布情况和耐药特征,为治疗提供经验指导。方法对我院2019年5月~2019年10月分离的208株肺炎克雷伯菌进行回顾性分析,其中产超广谱β-内酰胺酶(ESBLs)菌组47株,非产ESBLs菌组161株。结果肺炎克雷伯产ESBLs菌组与非产ESBLs菌组均主要来源于痰液,检出率显著高于其他标本来源;并且在ICU感染率最高,显著高于神经内科;产ESBLs菌组与非产ESBLs菌组肺炎克雷伯菌对β-内酰胺类和头孢菌素类的耐药率均显著高于其他抗菌药物,但这两组间药物耐药性基本一致。结论我院肺炎克雷伯菌的临床耐药率较高,应探索选择其他合适的抗菌药物,根据药敏结果结合临床感染情况,合理制定抗生素使用方案,为有效控制耐药菌产生和提高临床感染的治愈率发挥作用。Objective To analyze the characteristics of clinical distribution and drug resistance of Klebsiella pneumoniae(K.pneumoniae),and to provide guidance for clinical treatment.Methods A retrospective analysis was conducted on 208 strains of K.pneumoniae which isolated in our hospital from May 2019 to October 2019,among which 47 strains were in the Extended Spectyumβ-Lactamase(ESBLs)group and 161 were in the non-ESBLs group.Results Both the K.pneumoniae ESBLs-producing group and the non-ESBLs-producing group were mainly from sputum,and the detection rate was significantly higher than other sources.Moreover,the infection rate in ICU was the highest,which was significantly higher than that in neurology department.The drug resistance rate of the ESBLs-producing bacteria group and the non-ESBLs-producing bacteria group to ampicillin,cefazolin,ampicillin/sulbactam,ceftazidine and ceftriaxone was significantly higher than that of other antibiotics,but drug resistance was basically the same between the two groups,without significant difference.Conclusion The clinical drug resistance rate of K.pneumoniae is relatively high.According to the results of drug susceptibility and the clinical infection situation,the use of antibiotics can be reasonably formulated to effectively control the generation of drug-resistant bacteria and improve the cure rate of clinical infection.

关 键 词：肺炎克雷伯菌 耐药性 细菌分布 

分 类 号：R446.5[医药卫生—诊断学]