危重症医学科患者医院感染碳青霉烯类耐药肺炎克雷伯菌的耐药性及危险因素  

Drug Resistance and Risk Factors of Carbapenem-Resistant Klebsiella Pneumoniae in Hospital Infection of Critical Care Patients

作　　者：张荣芳 李天鹏 ZHANG Rongfang;LI Tianpeng(Department of Clinical Laboratory,the 83rd Group Military Hospital of the Chinese People’s Liberation Army,Xinxiang 453000,China)

机构地区：[1]陆军第八十三集团军医院检验科,河南新乡453000

出　　处：《河南医学研究》2025年第7期1244-1248,共5页Henan Medical Research

摘　　要：目的研究危重症医学科(ICU)患者院内感染碳青霉烯类耐药肺炎克雷伯菌(CRKP)的耐药情况同时分析与感染相关的危险因素。方法分别对2021年1月至2022年12月陆军第八十三集团军医院危重症医学科医院感染的65例CRKP、94例碳青霉烯类敏感肺炎克雷伯菌(CSKP)感染患者临床资料进行研究。与感染相关危险因素采用单因素及多因素logistic回归分析。结果陆军第八十三集团军医院ICU分离的CRKP主要来源于痰液标本,对替加环素、头孢他啶/阿维巴坦及多黏菌素B的敏感率较高。单因素分析表明低蛋白血症、住院时间≥14 d、抗生素使用种类≥3在CRKP组与CSKP组间差异有统计学意义(P<0.05);住院时间≥14 d、抗生素使用种类≥3为ICU患者感染CRKP的独立高危因素。结论危重症医学科感染CRKP形势严峻,及时改善患者蛋白营养不良、合理用药、缩短患者住ICU时间等可显著减少ICU患者院内CRKP的发生。Objective To investigate the drug resistance of carbapenem-resistant Klebsiella pneumoniae(CRKP)in hospital infection in intensive care unit(ICU)patients and analyze the risk factors associated with the infection.Methods Clinical data of 65 patients with CRKP and 94 patients with carbapenem-sensitive Klebsiella pneumoniae(CSKP)infected in ICU of the 83rd Group Military Hospital of the Chinese People’s Liberation Army from January 2021 to December 2022 were studied.The risk factors associated with infection were analyzed by univariate and multivariate logistic regression.Results The CRKP isolated from ICU of 83rd Army Group Military Hospital of the Chinese People’s Liberation was mainly derived from sputum samples,and the sensitivity rate of CRKP to tigacycline,ceftazidime/avibactam and polymyxine B was higher.Univariate analysis showed that hypoproteinemia,length of stay≥14 days,types of antibiotics used≥3 were statistically significant between the CRKP group and the CSKP group(P<0.05).Length of stay≥14 days and types of antibiotics used≥3 were independent risk factors for CRKP infection in ICU patients.Conclusion The incidence of CRKP in ICU patients can be significantly reduced by timely improvement of protein malnutrition,rational drug use and shortening of ICU stay.

关 键 词：碳青霉烯类耐药肺炎克雷伯菌 危险因素 危重症医学科 

分 类 号：R446.5[医药卫生—诊断学]