2015—2022年某院耐碳青霉烯类肺炎克雷伯菌分布及耐药性变迁  

Distribution and drug resistance variation of carbapenem-resistant Klebsiella pneumoniae in a hospital from 2015 to 2022

作　　者：伊怀文[1] 梁志强[1] 江玉凤 李仁哲[1] 李晓军 YI Huaiwen;LIANG Zhiqiang;JIANG Yufeng;LI Renzhe;Li Xiaojun(Medical Laborsty,the First People's Hospital of Jining Shandong,Jining,Shandong 272100,China;不详)

机构地区：[1]山东省济宁市第一人民医院医学检验科,山东济宁272100 [2]山东省济宁市微山县医院检验科

出　　处：《医学动物防制》2025年第3期309-312,F0003,共5页Journal of Medical Pest Control

基　　金：山东省医药卫生科技发展计划项目(202101060054)。

摘　　要：目的了解耐碳青霉烯类肺炎克雷伯菌的分布情况及其耐药性,为预防、控制和治疗相关感染提供科学依据。方法使用微生物统计软件Whonet 5.6分析2015年1月—2022年12月某院微生物实验室分离出的耐碳青霉烯类肺炎克雷伯菌患者信息、科室分布、标本种类和药敏试验,使用SPSS 22.0软件进行统计学分析。结果共检出耐碳青霉烯类肺炎克雷伯菌380株,检出率呈逐年波动上升;男性患者(75.26%,286/380)多于女性(24.74%,94/380),多数患者年龄大于45岁(86.58%,329/380)。科室分布,重症监护病房(intensive care unit,ICU)耐碳青霉烯类肺炎克雷伯菌检出最多(76.84%,292/380),不同年份该菌的检出率整体呈上升趋势(χ_(趋势)^(2)=44.151,P<0.001);标本分布,呼吸道标本检出耐碳青霉烯类肺炎克雷伯菌最多(56.58%,215/380);耐碳青霉烯类肺炎克雷伯菌对常见抗菌药物呈现出广泛耐药性,仅多黏菌素和替加环素耐药率较低。结论耐碳青霉烯类肺炎克雷伯菌在ICU患者中检出率高,细菌耐药率高,应制定合理防控措施,避免耐药菌株的产生和传播。Objective To understand the distribution and drug resistance of carbapenem-resistant Klebsiella pneumoniae,and to provide a scientific basis for the prevention,control,and treatment of related infections.Methods Information on patients with carbapenem-resistant Klebsiella pneumoniae isolated in the microbiology laboratory of a hospital,department distribution,specimen types,and drug sensitivity tests from January 2015 to December 2022 were analyzed using microbiology statistical software Whonet 5.6,and statistically analyzed using SPSS 22.0 software for statistical analysis.Results A total of 380 strains of carbapenem-resistant Klebsiella pneumoniae strains were detected,with the detection rate increasing in fluctuation year by year.There were more male patients(75.26%,286/380)than female patients(24.74%,94/380),and most of the patients were over 45 years old(86.58%,329/380).In the distribution of departments,carbapenem-resistant Klebsiella pneumoniae was detected most in intensive care unit(ICU)(76.84%,292/380),and the detection rate of this bacterium showed an overall upward trend in different years(χ_(trend)^(2)=44.151,P<0.001).In the distribution of specimens,carbapenem-resistant Klebsiella pneumoniae was detected most in respiratory specimens(56.58%,215/380).Carbapenem-resistant Klebsiella pneumoniae showed extensively drug resistant to common antibiotics,and only polymyxin and tigecycline showed a lower drug resistance rate.Conclusion Carbapenem-resistant Klebsiella pneumoniae has a high detection rate and a high rate of bacterial drug resistance in ICU patients.Reasonable prevention and control measures should be developed to avoid the generation and transmission of drug-resistant strains.

关 键 词：碳青霉烯 肺炎克雷伯菌 重症监护病房 革兰阴性杆菌 药敏试验 

分 类 号：R446.5[医药卫生—诊断学]