肺炎克雷伯菌的临床分布及其耐药特征  

Clinical distribution and drug resistance characteristics of Klebsiella pneumoniae

作　　者：张楠[1] 魏昕 彭慧斌 徐帅华 王晓萱 ZHANG Nan;WEI Xin;PENG Huibin;XU Shuaihua;WANG Xiaoxuan(Laboratory,Anyang Tumor Hospital(the Affiliated Anyang Tumor Hospital of Henan University of Science and Technology),Anyang,Henan 455000,China;Depertment of SurgeryⅡ,Anyang Tumor Hospital(the Affiliated Anyang Tumor Hospital of Henan University of Science and Technology),Anyang,Henan 455000,China)

机构地区：[1]安阳市肿瘤医院(河南科技大学附属安阳市肿瘤医院)医学检验科,河南安阳455000 [2]安阳市肿瘤医院(河南科技大学附属安阳市肿瘤医院)外二科,河南安阳455000

出　　处：《中国医学工程》2023年第4期88-93,共6页China Medical Engineering

摘　　要：目的 分析安阳市肿瘤医院的肺炎克雷伯菌(KPN)患者的临床分布及耐药性,为临床科室有效预防和控制感染及抗菌药物的合理使用提供依据。方法 对2020年10月至2022年4月不同标本来源及不同科室分离的KPN耐药性进行回顾性分析,剔除同一患者相同部位的重复菌株。结果 428株KPN标本主要来源于痰液(84.6%)、血液(5.1%);主要科室来源为ICU (36.5%)、胸外科(26.6%)、肿瘤外科(14.3%)。年龄来源主要为61~70岁(41.36%),各个年龄阶段的抗生素耐药性比较,差异无统计学意义(P>0.05)。产超广谱β-内酰胺酶菌株检出率为9.58%,耐碳青霉烯类药物菌株检出率为4.91%。产超广谱β-内酰胺酶菌株的耐药率大部分都高于非产超广谱β-内酰胺酶菌株,差异有统计学意义(P<0.05)。不同科室的抗生素耐药率在妇瘤科的耐药率最高,其次是胸外科和肿瘤外科。不同标本来源的抗生素耐药率在尿液标本中耐药率最高,其次是引流液和导管标本。结论 安阳市肿瘤医院KPN耐药性不容乐观,且某些抗生素的使用与耐药性有相关性。应提高临床合理使用抗生素水平,采取有效的防控措施,延缓耐药菌株的出现。【Objective】 To analyze the clinical distribution and the characteristics of drug resistance of Klebsiella pneumoniae(KPN) in Anyang Tumor Hospital,and to provide basis for effective prevention and control of infection and rational use of antibiotics in clinical departments.【Methods】 The drug resistance of KPN isolated from different samples and departments from October 2020 to April 2022 were retrospectively analyzed,and duplicated strains in the same part of the same patient were excluded.【Results】 The 428 K.pneumoniae strains were mainly isolated from sputum(84.6%) and blood(5.1%).ICU(36.5%),thoracic surgery(26.6%) and tumor surgery(14.3%) were the main sources of departments.Age sources were mainly 61 – 70 years old(41.36%),there was no significant difference in antibiotic resistance among different age groups(P>0.05).The detection rate of extended-spectrum beta-lactamases(ESBLs) producing strain was 9.58%,and the detection rate of carbapenem-resistant strain was 4.91%.The drug resistance rate of ESBLs-producing strain was higher than that of non-ESBLs-producing strain,and the difference was statistically significant(P<0.05).Antibiotic resistance rate of different departments was the highest in gynecomatology department,followed by thoracic surgery and tumor surgery department.Antibiotic resistance rate of urine samples was the highest,followed by drainage fluid and catheter samples.【Conslusion】 KPN resistance in our hospital is not optimistic,and the use of some antibiotics is correlated with drug resistance.The clinical rational use of antibiotics should be improved,and effective prevention and control measures should be taken to delay the emergence of drug-resistant strains.

关 键 词：肺炎克雷伯菌 耐药性 抗菌药物 超广谱Β-内酰胺酶 

分 类 号：R446.5[医药卫生—诊断学]