摘要
目的:了解江西中医药大学附属医院肺炎克雷伯菌(KPN)的临床分布情况并分析其耐药性变化。方法:收集江西中医药大学附属医院2016—2019年非重复临床分离KPN,采用MicroScan WalkAway 96全自动微生物分析仪进行细菌鉴定和药物敏感性试验,参照美国临床实验室标准化协会标准判断结果,并将结果用Whonet 5.6软件进行统计学分析,分析其临床分布及耐药情况。结果:收集KPN菌株共622株,患者多分布在61~70岁、71~80岁、81~90岁3个年龄段,分别占比25.24%、23.95%、19.94%;科室分布主要为心血管科、呼吸科、肾病科、神经内科、康复科、消化科等;标本来源主要为痰液(39.23%)、尿液(38.10%)、分泌物(10.45%)、血液(7.07%)、脓液(2.25%)等。药敏情况为:KPN对哌拉西林呈现高耐药率,对碳青霉烯类抗生素厄他培南、亚胺培南耐药率较低;2019年分离的KPN对头孢噻肟、头孢吡肟、氨曲南等的耐药率较2016—2018年明显升高(P<0.05)。结论:KPN患者临床分布广泛,以老年患者居多,标本来源主要为痰液、尿液等,对临床常用抗菌药物耐药程度各一。应积极倡导临床抗生素的合理使用,加强KPN的耐药性监测,降低耐药率,避免KPN院内感染暴发。
Objective:To understand the clinical distribution and drug resistance of Klebsiella pneumoniae(KPN)in hospital.Methods:To Collecte the clinical isolated Klebsiella Pneumonia from The Affiliated Hospital of Jiangxi University of Chinese Medicine in 2016-2019,adopt the MicroScan WalkAway 96 automatic microbial analyzer to identify the bacteria and drug sensitivity test,with reference to the American association of clinical laboratory standardization standard,and the software of Whonet 5.6 is used to statistical analysis,analysis of the clinical distribution and drug resistance.Results:A total of 622 KPN strains were collected in our hospital,with the majority of patients aged 61-70,71-80,and 81-90,accounting for 25.24%,23.95%and 19.94%.The source departments are mainly distributed in cardiovascular department,respiratory department,nephrology department,neurology department,rehabilitation department,gastroenterology department,etc.The main sources of specimens were sputum(39.23%),urine(38.10%),secretions(10.45%),blood(7.07%)and pus(2.25%),etc.Drug sensitivity:KPN showed high drug resistance rates to Piperacillin,The drug resistance rates of Ertapenem and Imipenem were low.The drug resistance rate of KPN isolated in 2019 against cefotaxime,cefepime and amtrinanan was significantly higher than that from 2016 to 2018(P<0.05).Conclusion:KPN patients in our hospital are widely distributed clinically,mostly in elderly patients,specimens mainly come from sputum,urine,etc.,resistance to commonly used antibiotics in clinic is different.We should actively advocate the rational use of clinical antibiotics,strengthen the surveillance of drug resistance,reduce drug resistance rate,and avoid the outbreak of nosocomial infection.
作者
金桂林
杨小军
肖亮
俞凤
陶霄
杨军平
JIN Gui-lin;YANG Xiao-jun;XIAO Liang;YU Feng;TAO Xiao;YANG Jun-ping(The Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang 330006,China)
出处
《江西中医药大学学报》
2023年第4期40-42,46,共4页
Journal of Jiangxi University of Chinese Medicine
基金
江西省卫计委中医药科研项目(2017A277)。
作者简介
通信作者:杨军平,硕士,主任技师。E-mail:89757520@qq.com。
