某医院烧伤科患者感染肺炎克雷伯菌的特点及耐药性调查

Investigation on the characteristics and drug resistance of Klebsiella pneumoniae infection of burn patients in a hospital

目的了解某医院烧伤科患者感染肺炎克雷伯菌的分布及其耐药情况,为临床合理选用抗菌药物提供科学依据。方法采用细菌培养鉴定技术和药敏试验方法,对某医院烧伤科患者送检标本检测与分析。结果从该医院烧伤科住院患者送检的病原学标本中共检出肺炎克雷伯菌153株,检出率呈上升趋势;其中耐碳青霉烯类肺炎克雷伯菌(CRKP)菌株占37.91%。CRKP在不同烧伤面积、不同年龄、有混合感染检出率差异有统计学意义(P<0.05)。肺炎克雷伯菌对亚胺培南、头孢他啶、头孢吡肟、呋喃妥因、头孢呋辛、头孢哌酮/舒巴坦和头孢噻肟的耐药率均呈逐年上升的趋势(P<0.05)。结论该医院烧伤科患者感染肺炎克雷伯菌对多数常用抗菌药物的耐药率呈上升趋势,尤其对碳青霉烯类抗菌药物,临床需要根据药物敏感试验合理选用抗菌药物,防止多重耐药菌的流行与传播。

Objective To investigate the distribution and drug resistance of Klebsiella pneumoniae infection in hospital burn patients,and to provide scientific basis for the rational selection of antimicrobial drugs in clinic.Methods Bacterial culture identification technology and drug sensitivity test method were used to detect and analyze the specimens sent from burn patients in a hospital.Results A total of 153 strains of Klebsiella pneumoniae were detected from the pathogenic specimens submitted from inpatients in the burn department of the hospital,and the detection rate showed an increasing trend;the most commonly isolated strains were from wound secretions.CRKP strains accounted for 37.91%of the Klebsiella pneumoniae isolated from the burn department.The detection rate of CRKP in different burn areas,different ages and mixed infections was statistically significant(P<0.05).The resistance rates of Klebsiella pneumoniae to Imipenem,Ceftazidime,Cefpime,Furantoin,Cefuroxime,Cefoperazone/Sulbactam,and Cefotaxime all showed an increasing trend year by year(P<0.05).Conclusion The resistance rate of Klebsiella pneumoniae to most commonly used antibacterials in patients with burn injury in this hospital is on the rise,especially for Carbapenem antibacterials.It is necessary to select antibacterials reasonably according to drug sensitivity test in the clinic to prevent the spread of multi-drug resistant organisms.