重症监护病房患者检出耐碳青霉烯类肺炎克雷伯菌的危险因素分析  

Analysis of risk factors for carbapenem-resistant Klebsiella pneumoniae detected in ICU patients

作　　者：王欣 沈丹丹 刘银梅[1] 钱香玲 袁应华[2] 余红[1] WANG Xin;SHEN Dandan;LIU Yinmei;QIAN Xiangling;YUAN Yinghua;YU Hong(Department of Infection and Disease Control,Shanghai Tenth People's Hospital,Shanghai 200072,P.R.China;Laboratory Microbiology Laboratory,Shanghai Tenth People's Hospital,Shanghai 200072,P.R.China)

机构地区：[1]上海市第十人民医院院内感染与疾病控制处,上海200072 [2]上海市第十人民医院检验科微生物实验室,上海200072

出　　处：《中国呼吸与危重监护杂志》2022年第3期158-161,共4页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的探究我院重症监护病房患者肺炎克雷伯菌的定植情况并进行危险因素分析。方法主动筛查医院2020年6月—12月期间外科重症监护病房和神经外科重症监护病房的患者226例,对其临床资料进行回顾性分析。结果筛查出87株肺炎克雷伯菌,69株为耐碳青霉烯类肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP),耐药基因型主要为KPC基因型(79.6%),对亚胺培南、美罗培南的耐药率分别为75.0%、77.4%。年龄、入院前肺部感染是CRKP定植的危险因素,入院前肺部感染是CRKP定植的独立危险因素。结论我院重症监护病房患者CRKP定植率高,且对碳青霉烯类抗菌药物耐药率较高,入院前肺部感染是CRKP定植的独立危险因素。Objective To explore the colonization of Klebsiella pneumoniae in the intensive care unit of our hospital and analyze the risk factors.Methods A total of 226 patients were actively screened in the surgical intensive care unit and neurosurgery intensive care unit from June to December 2020 in the hospital,and their clinical data were retrospectively analyzed.Results Totally,87 strains of Klebsiella pneumoniae were screened out,69 strains were carbapenem-resistant Klebsiella pneumoniae(CRKP),and the resistant genotype was mainly KPC genotype(79.6%).The resistance rates of meropenem were 75.0%and 77.4%,respectively.Age and pulmonary infection before admission are risk factors for CRKP colonization,while pulmonary infection before admission is an independent risk factor for CRKP colonization.Conclusions Both the CRKP colonization rate of patients and the rate of resistance to carbapenem antimicrobials are relatively high in the intensive care unit of our hospital.Pulmonary infection before admission is an independent risk factor for CRKP colonization.

关 键 词：重症监护病房 肺炎克雷伯菌 耐碳青霉烯类 危险因素 耐药基因型 

分 类 号：R446.5[医药卫生—诊断学]