摘要
目的探讨血清炎性因子联合微生物检验对耐药肺炎克雷伯菌脓毒症诊断和预后情况。方法择取2019年3月至2020年10月就诊的脓毒症患者122例(其中A组严重脓毒症患者50例,B组脓毒症患者72例),另外同时期收集体检的健康人员60例设为对照组,对3组受检者均进行实验室相关指标检测,对其检测数据进行综合分析。结果A组患者炎性因子水平(血清PCT、CRP、IL-6)与B组、对照组比较均明显较高(P<0.05);B组患者的炎性因子水平(血清PCT、CRP、IL-6)与对照组比较均明显较高(P<0.05);脓毒症患者病原菌共计285株,其中革兰阴性菌株共计191株,肺炎克雷伯菌36株,占12.63%,革兰阳性菌株共计94株,占32.98%,真菌5株,占比1.75%;肺炎克雷伯菌的耐药性对头孢唑啉、头孢呋辛、氨曲南、头孢曲松、头孢他啶耐药率>47%,而对妥布霉素、左氧氟沙星、亚胺培南、厄他培南、替加环素肺克的耐药率相对较低。结论临床上应加强对耐药肺炎克雷伯菌脓毒症患者的关注,及时进行实验室指标检测,随着病情严重程度的递增,各项血清炎性因子水平随之递增,临床诊疗时需高度关注患者的实验室检测数据,综合分析其预后,控制疾病的继续发展。
Objective To investigate the diagnosis and prognosis of drug-resistant Klebsiella pneumoniae sepsis by combined detection of serum inflammatory factors and microorganisms.Methods A total of 122 patients with sepsis who were treated in our hospital from March 2019 to October 2020 were enrolled in the study,including 50 patients with severe sepsis in group A and 72 patients with sepsis in group B,at the same time,the other 60 healthy subjects who underwent physical examination in our hospital were enrolled as control group.The laboratory related indexes were detected and compared among thew three groups,and the detection data were analyzed synthetically and statistically.Results The levels of inflammatory factors including PCT,CRP,IL-6 in group A were significantly higher than those in group B and control group(P<0.05),moreover,which in group B were significantly higher than those in control group(P<0.05).There were 285 strains of pathogenic bacteria in patients with sepsis,in which,191 strains were gram-negative bacteria,and 36 strains were Klebsiella pneumoniae,94 strains were gram-positive bacteria,accounting for 32.98%,and 5 strains were fungi,accounting for 1.75%.The drug resistance rate of Klebsiella pneumoniae to cefazolin,cefuroxime,tronam,ceftriaxone and ceftazidime was above 47%,however,its drug resistance rate to tobramycin,levofloxacin,imipenem,ertapenem,tegacycline lung gram was relatively lower.Conclusion It is necessary to strengthen the drug-resistant pneumonia klebsiella bacteria in clinical practice for the patients sepsis,timely detect the related laboratory indicators,moreover,it is necessary to pay much attention to the laboratory test data,and to comprehensively analyze the prognosis to control the progress of disease.
作者
程子嘉
陈诚
李新科
CHENG Zijia;CHEN Cheng;LI Xinke(Department of Clinical Laboratory,Funan County People’s Hospital,Anhui,Funan 236300,China)
出处
《河北医药》
CAS
2022年第24期3824-3826,共3页
Hebei Medical Journal
关键词
耐药肺炎克雷伯菌
脓毒症
血清炎性因子
检验
微生物
drug-resistant Klebsiella pneumoniae
sepsis
serum inflammatory factor
detection
microorganisms
