198例院内肺炎克雷伯菌肺炎调查分析

Infection Analysis on 198 Patients with Nosocomial Pneumonia Caused by Klebsiella pneumoniae

目的探讨院内肺炎克雷伯菌(Kpn)肺炎的临床特点及细菌耐药情况。方法采用回顾性病例调查方法,对我院198例院内Kpn肺炎患者的基础疾病和抗菌药应用情况进行分析,并将患者痰培养获得的201株Kpn菌株进行药敏分析。结果51.5%的Kpn肺炎发生在慢性阻塞性肺疾病和急性脑血管病患者中,所有病例均在发病前使用了抗菌药,联合用药172例(86.87%)。有62株Kpn(30.85%)为产超广谱β-内酰胺酶(ESBL)菌株,产ESBL菌株对青霉素类、喹诺酮类、氨基糖苷类、头孢菌素类均具有很高的耐药率,对亚胺培南未产生耐药现象。结论合理使用抗菌药,防止耐药株产生,是预防和控制医院感染的主要措施。

Objective To explore the clinical feature of pneumonia caused by Klebsiella pneumoniae and the antibiotic resistance of the bacteria. Methods Based on the 7-year surveillance database, a case review study was conducted to analyze 198 cases on basic diseases and antibiotics application with nosocomial pneumonia caused by Klebsiella pneumoniae. Antimicrobial susceptibility testing was carried out in 201 strains of Klebsiella pneumoniae isolated from sputum culture specimens. Result 51.5% of pneumonia caused by Klebsiella pneumoniae appeared in chronic obstructive pulmonary disease and acute cerebrovascular disease. Before sickness, antibiotics were applied in all cases and combined application held 172 cases （86.9%）. The abuse of third-generation cephalosporins was one of the most important factors in inducing the resistance to Klebsiella pneumoniae. Conclusion Appropriate use of antibiotics, particularly the thirdgeneration cephalosporins is essential to prevent occurrence of drug resistance, prevent and control nosocomial infections.