某医院ICU与普通病房肺炎克雷伯菌耐药性对比分析  

A Comparative Study of Antimicrobial Resistance of Klebsiella Pneumoniae Between ICU and General Wards in a Hospital

作　　者：税剑 马小华[1] 石国民[1] 潘建华[1] 梁仙志 齐志强[1] 石燕[1] 向延根[1] SHUI Jian;MA Xiaohua;SHI Guoming;PAN Jianhua;LIANG Xianzhi;QI Zhiqiang;SHI Yan;XIANG Yangen(Department of Clinical Laboratory, Changsha Central Hospital, Changsha 410004,China)

机构地区：[1]长沙市中心医院检验科,湖南长沙410004

出　　处：《标记免疫分析与临床》2021年第11期1860-1864,共5页Labeled Immunoassays and Clinical Medicine

基　　金：湖南省卫生健康委科研课题(编号:202111000032);长沙市科技局课题(编号:kq2004166)。

摘　　要：目的分析某医院ICU与普通病房肺炎克雷伯菌感染的临床分布及耐药性差异,为临床合理使用抗菌药物提供科学依据。方法采用VITEK-2 Compact全自动微生物鉴定及药敏分析系统对本院2020年临床分离的肺炎克雷伯菌进行鉴定及药敏实验,比较分析ICU与普通病房肺炎克雷伯菌耐药性差异。结果ICU与普通病房送检标本均以痰标本为主,分别占74.1%、67.1%。全院检出的肺炎克雷伯菌对氨苄西林/舒巴坦、头孢曲松、呋喃妥因具有较高的耐药性,耐药率分别达57.4%、53.6%、51.5%,对碳青霉烯类抗生素保持较高的敏感性,敏感率均在70%以上。ICU检出的肺炎克雷伯菌对呋喃妥因的耐药率最高,高达92.3%,对氨苄西林/舒巴坦、氨曲南、复方新诺明、环丙沙星、头孢吡肟、头孢曲松、头孢他啶的耐药率也高达50%以上;普通病房检出的肺炎克雷伯菌对呋喃妥因的耐药率达87%,对氨苄西林/舒巴坦、头孢曲松的耐药率分别为59.4%、51.6%。ICU检出的肺炎克雷伯菌对被检的18种抗生素中,除阿米卡星、庆大霉素外,其余抗生素的耐药率均高于普通病房,差异具有统计学意义(P<0.05)。结论ICU检出的肺炎克雷伯菌的耐药率高于普通病房,应引起临床高度重视;抗感染过程中,应根据药敏结果合理选择抗菌药物。Objective To analyze the clinical distribution and antimicrobial resistance of Klebsiella pneumoniae between ICU and general wards of a hospital,and to provide a scientific knowledge basis for the rational use of antibiotics in clinical practice.Methods Identification and antimicrobial susceptibility testing of Klebsiella pneumoniae isolated in our hospital in 2020 were performed by VITEK-2 compact automatic microbial identification and antimicrobial agents sensitivity analysis system.Antimicrobial resistance results of Klebsiella pneumoniae between ICU and general wards were compared.Results The tested specimens were mainly sputum in both ICU and general wards,accounting for 74.1%and 67.1%,respectively.Klebsiella pneumoniae detected in the whole hospital showed high resistances to ampicillin/sulbactam,ceftriaxone and furantoin,accounting for 57.4%,53.6%and 51.5%,respectively.Klebsiella pneumoniae maintained high sensitivity to carbapenems antibiotics,with sensitivity rates of more than 70%.The resistance rate of Klebsiella pneumoniae detected in ICU to furantoin was the highest,up to 92.3%,and resistance rates to ampicillin/sulbactam,aztreonam,trimethoprim/sulfamethoxazole,ciprofloxacin,cefepime,ceftriaxone and ceftazidime were also higher than 50%.The resistance rates of Klebsiella pneumoniae detected in general wards to furantoin,ampicillin/sulbactam and ceftriaxone were 87%,59.4%and 51.6%,respectively.The resistance rates of Klebsiella pneumoniae detected in ICU to 18 kinds of antibiotics except amikacin and gentamicin were higher than those in general wards,and the differences were statistically significant(P<0.05).Conclusion The resistance rate of Klebsiella pneumoniae detected in ICU is higher than that in general wards,which should be paid more attention.Antibiotics should be reasonably selected for the clinical treatment of infection according to antimicrobial susceptibility testing results.

关 键 词：普通病房 肺炎克雷伯菌 感染 耐药性 

分 类 号：R378[医药卫生—病原生物学]