摘要
目的:回顾性分析长沙某医院分离592株肺炎克雷伯菌的临床特征及耐药情况,为院感防控和抗菌治疗提供依据。方法:收集2018年7月~2019年6月该医院分离出的非重复592株肺炎克雷伯菌,进行标本来源、科室分布等临床特征分析,同时分析其耐药特点,并对产碳青霉烯酶肺炎克雷伯菌(CRKP)进行改良碳青霉烯灭活试验(mCIM实验)联合EDTA改良碳青霉烯灭活试验(eCIM实验)以确定产碳青霉烯酶类型。结果:在分离得到的592株肺炎克雷伯菌中,标本分布以痰液(52.7%)为主,其次为尿液(20.1%)、血液(10.5%)等;科室分布以重症医学科(27.5%)为主,其次为呼吸内科(20.8%)、神经内外科(13.7%)、中医科(9.3%)等。该菌对头孢菌素、氨苄西林/舒巴坦、替卡西林/克拉维酸等临床抗生素耐药率超过45%;而CRKP几乎对临床常用抗菌全部耐药,仅对替加环素、阿米卡星、米诺环素保持较低耐药率,其中CRKP以产丝氨酸碳青霉烯酶为主。结论:临床感染KPN现状严峻,耐药程度较高,特别是CRKP几乎对所有临床常用抗生素耐药,因此急需临床合理使用抗菌药物,并加强对该菌监测好。
Objective The clinical characteristics and drug resistance of 592 strains of Klebsiella pneumoniae isolated from a hospital of Changsha were analyzed retrospectively so as to provide the basis for hospital prevention and control,and antibacterial treatment.Method From July 2018 to June 2019,592 strains of Klebsiella pneumoniae isolated from this hospital were collected and analyzed for their clinical characteristics,such as specimen sources and department distribution.Also,the drug resistance characteristics of Klebsiella pneumoniae was analyzed,and the modified carbapenem inactivation test(mCIM test)combined with EDTA modified carbapenem inactivation test(eCIM test)was carried out to determine the type of Carbapenem resistant Klebsiella pneumoniae(CRKP).Results Among the 592 strains of Klebsiella pneumoniae isolated,sputum(52.7%),urine(20.1%)and blood(10.5%)were the main specimen sources.The distribution of the departments was mainly the intensive medical science(27.5%),followed by the respiratory medicine(20.8%),the neurosurgery(13.7%),the traditional Chinese medicine section(9.3%)and so on.The resistance rate of Klebsiella pneumoniae to cephalosporins,ampicillin/sulbactam,ticarcillin/clavulanic acid and other clinical antibiotics was more than 45%,while CRKP was almost all resistant to tetracycline,amikacin and minocycline.And most of them produce serine carbapenemase.Conclusion The present situation of clinical infection of KPN is serious and the degree of drug resistance is high,especially CRKP is resistant to almost all the commonly used antibiotics in clinic.So,it is urgent to use antibiotics reasonably in clinical practice and to strengthen the monitoring of the bacteria.
作者
侯正利
张毕明
张冉
王远懿
Hou Zheng-li;Zhang Bi-ming;Zhang Ran;Wang Yuan-yi(Department of Clinical Laboratory,the Fourth Hospital of Changsha,Changsha 410006,China;Hunan Normal University School of Medicine,Changsha 410013,China)
出处
《湖南师范大学学报（医学版）》
2020年第2期18-20,共3页
Journal of Hunan Normal University(Medical Sciences)
基金
长沙市科技计划项目(kq1907012)
2018年湖南省财政厅专项科技项目.
作者简介
通讯作者:张毕明,E-mail:297484384@qq.com;通讯作者:张冉,E-mail:zhangrankp@qq.com
