呼和浩特市某三甲医院肺炎克雷伯菌的科室分布及耐药特点  

Department distribution and antibiotics resistance of Klebsiella pneumoniae in a tertiary hospital locates in Hohhot

作　　者：何查荣 王华[2] 孙祺 王俊瑞[2] 韩艳秋[2] 胡志德 郑文琪 HE Charong;WANG Hua;SUN Qi;WANG Junrui;HAN Yanqiu;HU Zhide;ZHENG Wenqi(First Clinical Medical School,Inner Mongolia Medical University,Hohhot 010050;Department of Laboratory Medicine,Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学第一临床医学院,呼和浩特010050 [2]内蒙古医科大学附属医院检验科,呼和浩特010050

出　　处：《临床与病理杂志》2022年第3期595-600,共6页Journal of Clinical and Pathological Research

基　　金：内蒙古自治区自然科学基金(2020MS08126);内蒙古医科大学第一临床医学院大学生“启蒙计划”(FYQMJH2020017)。

摘　　要：目的:调查2016至2019年呼和浩特某三甲医院肺炎克雷伯菌(Klebsiella pneumoniae,KP)临床分离株的科室、标本分布以及对抗生素的敏感性,为临床制定合理的抗感染方案提供参考。方法:回顾性分析内蒙古医科大学附属医院2016年1月至2019年12月临床分离的2 975株KP菌株的临床资料。采用VITEK 2 Compact全自动细菌鉴定药敏分析仪进行药敏试验,药敏结果判读参考美国临床和实验室标准化协会(Clinical and Laboratory Standards Institute,CLSI)中M100-S23的标准执行,数据结果用WHONET 5.6统计软件分析。结果:临床送检的各类标本中,共检出KP菌株2 975株,菌株的标本来源主要是痰液(61.24%,1 822/2 975)和尿液(26.82%,798/2 975)。临床科室中分离率较高的是呼吸科(14.22%,423/2 975)、外科(11.19%,333/2 975)和重症监护病房(intensive care unit,ICU)(9.34%,278/2975)。药敏结果显示:分离的KP菌株主要对环丙沙星、头孢曲松和头孢唑啉耐药率较高;对头孢他啶、哌拉西林/他唑巴坦、美罗培南与亚胺培南的耐药率呈逐年上升趋势。结论:KP已呈现多耐药甚至广泛耐药趋势,临床科室尤其应关注耐碳青霉烯类抗生素的KP分离株,根据药敏结果及临床感染情况合理制定治疗方案。Objective: To investigate the department distribution and antibiotics resistance of Klebsiella pneumoniae(KP) in a tertiary hospital located in Hohhot, as well as providing evidence for clinical decisions for KP infected patients. Methods: In this retrospective analysis, we collected the clinical and antibiotics resistance characteristics of 2 975 strains of KP isolated from the Affiliated Hospital of Inner Mongolia Medical University from January 2016 to December 2019. The VITEK 2 Compact automated analyzer was used for antibiotics susceptibility testing. The drug susceptibility results were interpreted in accordance with the American Clinical and Laboratory Standards Institute(CLSI) M300-S23 guideline. The collected data were analyzed by WHONET 5.6 statistical software. Results: Among the 2 975 non-duplicated clinical isolates, the main sources of strain specimens were sputum(61.24%, 1 822/2 975) and urine(26.82%, 798/2 975). The clinical departments were mainly distributed in the Department of Respirology(14.22%, 423/2 975), Surgery(11.19%, 333/2 975) and Intensive Care Unit(9.34%, 278/2 975). The isolated KP were mainly resistant to ciprofloxacin, ceftriaxone, and cefazolin. The resistance rate to ceftazidime, piperacillin/tazobactam, meropenem and imipenem were increased from 2016 to 2019. Conclusion: KP strains have shown multi-drug resistance or even extensive drug resistance trends. Clinicians should pay special attention to carbapenem-resistant isolates. The treatment approach for KP infection should be based on clinical characteristics, especially the result of antibiotics resistance testing.

关 键 词：肺炎克雷伯菌 流行病学 耐药性 耐碳青霉烯类 

分 类 号：R446.5[医药卫生—诊断学] R96[医药卫生—临床医学]