68例老年肺炎克雷伯菌医院感染的临床分布

Klebsiella pneumoniae Strains from Nosocomial Infection in Senile Patients:Their Clinical Distribution and Drug Resistance

目的探讨老年肺炎克雷伯菌医院感染的临床分布和耐药情况. 方法对我院2002年1月～2003年12月68例老年肺炎克雷伯菌医院感染病例进行回顾性分析. 结果老年肺炎克雷伯菌医院感染部位以下呼吸道为主;基础疾病则为恶性肿瘤的感染率最高;老年肺炎克雷伯菌对亚胺培南、美罗培南、复方新诺明、头孢哌酮/舒巴坦敏感性较高,而对氨苄西林、头孢唑林耐药较为严重;产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌对14种常用抗菌药物的耐药率与非产ESBLs肺炎克雷伯菌差异无显著性. 结论高龄、严重基础疾病、侵入性操作、大量广谱抗菌药物的使用是老年肺炎克雷伯菌医院感染的易感因素,对抗菌药物的耐药性有逐年增加的趋势.

OBJECTIVE To discuss the clinical distribution and drug resistance of Klebsiella pneumoniae strains from nosocomial infection in senile patients. METHODS The analysis of 68 senile patients infection with Klebsiella strains from nosocomial infection in our hospital from Jan 2002 to Dec 2003 was reviewed. RESULTS The main infection site of K. pneumoniae strains in senile patients was the lower airways among basic diseases, the patients with malignancy were the most easily infected with these strains; the K. pneumoniae in senile was comparatively more sensitive to imipenem, meropenem, trimethoprim/sulfamethoxazole, and cefoperazone/sulbactam, but quite resistant to ampicillin and cephazoline; the resistance to 14 commonly used antibiotics between extended spectrum β-lactamases and non extended spectrum β-lactamases had no significant difference. CONCLUSIONS The advanced age, severe basic diseases, invasive operations and broad spectrum antibiotics abused are the risk factors, which make senile patients easily infected with K. pneumoniae strains from nosocomial infection, morever, the strains have the trend to gradually become more and more serious with the year increased.