肺炎克雷伯菌的分布及耐药性变化分析  

Distribution and drug resistance of Klebsiellapneumoniae

作　　者：袁忠林[1] 王鸿 YUAN Zhonglin;WANG Hong(Department of Clinical Laboratory Medicine,Huaian Hospital of Traditional Chinese Medicine,Jiangsu Huaian 223001)

机构地区：[1]江苏省淮安市中医院检验科,江苏淮安223001

出　　处：《医学检验与临床》2023年第8期20-25,共6页Medical Laboratory Science and Clinics

摘　　要：目的:对2019年-2021年临床科室送检样本中培养出的肺炎克雷伯菌(KP)进行统计和分析,以了解本院患者肺炎克雷伯菌引发感染的科室分布和耐药性,以求为临床用药提供一定的合理性指导。方法:收集相应年度临床送检的样本,并以对应样本中检出的肺炎克雷伯菌为资料进行统计、回顾性分析,研究其三年来在本院所引起临床感染的科室分布以及耐药性的特征。结果:临床样本中KP检出率呈逐年增高态势,以ICU、康复、骨科/脑外等科室增多为著,样本主要为痰、脓、尿等;KPCRE、KP-CRE/ESBL等耐药菌检出株数也逐年增多,临床常用药物的耐药率有逐年上升的趋势,其中亚胺培南等碳青霉烯类、头孢呋辛、头孢哌酮舒巴坦、哌拉西林舒巴坦等耐药率均显著增高;近三年,痰样本分离出肺炎克雷伯菌株数呈逐年增多趋势,存在显著性差异,P<0.01。结论:针对本院患者检出的KP及其耐药菌株在ICU等重点科室分布较多,又以呼吸道等感染性样本为主,且其耐药率呈逐年增长的趋势,故其已成为本院院内感染的主要危险菌株之一。Objective:To conduct statistical analysis of Klebsiellapneumoniae(KP)cultured from samples submitted for examination in clinical departments from 2019 to 2021,in order to understand the department distribution and drug resistance of Klebsiellapneumoniae induced infection in patients in our hospital,in order to provide reasonable guidance for clinical drug use.Methods:Clinical samples were collected in corresponding years,and Klebsiellapneumoniae detected in corresponding samples were used for statistical and retrospective analysis,to study the distribution of departments causing clinical infection and the characteristics of drug resistance in our hospital in the past three years.Results:The detection rate of KP in clinical samples showed an increasing trend year by year,especially in ICU,rehabilitation,orthopedics/extracerebral departments.The samples were mainly sputum,pus,urine,etc.The detected number of drug-resistant bacteria such as KPCRE,KP-CRE/ESBL also increased year by year,and the drug resistance rate of commonly used clinical drugs showed an increasing trend year by year,among which the drug resistance rates of carbapenems such as imipenem,cefuroxime,cefoperazonesulbactam,piperacillinsulbactam were significantly increased.In recent three years,the number of Klebsiellapneumoniae isolates from sputum samples showed an increasing trend year by year,with significant difference(P<0.01).Conclusion:KP and its drug-resistant strains detected in patients in our hospital are more distributed in ICU and other key departments,and mainly in respiratory tract and other infectious samples,and its drug resistance rate shows an increasing trend year by year,so KP has become one of the main dangerous strains of nosocomial infection in our hospital.

关 键 词：肺炎克雷伯菌 临床科室分布 样本分布 耐药性变化 

分 类 号：R446.5[医药卫生—诊断学]