2016~2022年某医院临床分离肺炎克雷伯菌的临床分布及耐药性变化分析  

A Study of the Clinical Distribution and Drug Resistance of Klebsiella Pneumoniae Isolated From a Hospital From 2016 to 2022

作　　者：孟祥兆 邢国征 徐婷[1] 徐丽 周小凤 赵光轮 于洪远[1] MENG Xiangzhao;XING Guozheng;XU Ting;XU Li;ZHOU Xiaofeng;HAO Guanglun;YU Hongyuan(Department of Laboratory Medicine,Beijing Aerospace General Hospital,Beijing 100076;Department of Science and Education,Beijing Aerospace General Hospital,Beijing 100076)

机构地区：[1]北京航天总医院检验科,北京100076 [2]北京航天总医院科教处,北京100076

出　　处：《标记免疫分析与临床》2024年第4期609-615,669,共8页Labeled Immunoassays and Clinical Medicine

基　　金：北京航天总医院创新基金科研立项(编号2023-720)。

摘　　要：目的通过分析2016~2022年某医院临床分离的肺炎克雷伯菌药物敏感性的变化,指导临床合理用药,控制肺炎克雷伯菌引发的感染。方法对2016~2022年期间临床患者送检标本分离出的肺炎克雷伯菌进行培养、鉴定、药物敏感试验,对肺炎克雷伯菌感染重点科室及医院每年的抗菌药物敏感率进行数据回顾性分析。结果2016~2022年临床送检样本共分离出病原菌17827株,其中肺炎克雷伯菌2963株,占16.6%;检出率在重症监护病房由16.4%上升至34.8%、呼吸内科、神经内科、老年病医学科的检出率在20%左右;肺炎克雷伯菌中产超广谱β内酰胺酶(ESBL)菌株的检出率在15%~25%之间。7年期间肺炎克雷伯菌对抗菌药物敏感性总体呈下降趋势,ICU分离到的菌株对亚胺培南的敏感率由59.8%下降至28.8%,其他3个重点科室:呼吸内科、神经内科、老年病医学科在菌株的药物敏感性上没有明显变化。结论肺炎克雷伯菌是本医院临床样本分离到的重要临床菌株,其体外药物敏感性变化与临床用药、治疗、患者预后及医疗成本控制有密切关系,医院应加强对其监测、预防及感染控制。Objective To analyze the change of drug sensitivity of Klebsiella pneumoniae isolated in our hospital from 2016 to 2022,so as to guide clinical rational drug use and control for the infection caused by Klebsiella pneumoniae.Methods Klebsiella pneumoniae isolated from clinical patients during 2016-2022 were cultured,and then tested for drug sensitivity.The data of antimicrobial susceptibility rate in key departments and hospitals with Klebsiella pneumoniae infection were analyzed retrospectively.Results From 2016 to 2022,17,827 strains of pathogenic bacteria were isolated,of which 2963(16.6%)were Klebsiella pneumoniae.The detection rate increased from 16.4%to 34.8%in Intensive Care Unit(ICU).The detection rate of Departments of Respiratory Medicine,Neurology and Geriatrics was about 20%.The detection rate of Extended-spectrumβ-lactmase(ESBL)in Klebsiella pneumoniae was 15%-25%.The sensitivity of Klebsiella pneumoniae to antibiotics decreased from 59.8%to 28.8%in ICU,while rates for the other three key departments:Respiratory Medicine,Neurology,Geriatrics Medicine in the strain of drug sensitivity were not significantly different.Conclusion Klebsiella pneumoniae is an important Clinical strains from clinical samples in our hospital.Changes of drug sensitivity of Klebsiella pneumoniae in vitro are closely related to clinical medication,treatment,prognosis of patients and control of medical cost.The hospital should strengthen its surveillance,prevention and infection control.

关 键 词：肺炎克雷伯菌 耐碳青霉烯类肺炎克雷伯菌 药物敏感性实验 临床合理用药 

分 类 号：R378[医药卫生—病原生物学]