肺炎克雷伯菌感染328例检测与分析

Analysis of 328 Patients Infected by Klebisella Pneumoniae

目的及早发现与控制耐药菌的产生与播散,为肺炎克雷伯菌肺部感染的诊断和治疗提供依据。方法采用VITEK-AMS系统(法国生物梅里埃公司生产)鉴定肺炎克雷伯菌,GNI卡鉴定到种。回顾性分析328例肺炎克雷伯菌感染患者的临床表现及耐药情况。结果328例患者中93.8%有基础疾病,临床症状以发热、咳嗽、咳痰为主,胸部X线以肺大叶实变(28.2%)、小叶浸润(53.4%)和肺脓肿(18.4%)的形成为主要病变。肺炎克雷伯菌的耐药率较高。结论非典型表现的肺炎克雷伯菌感染有增加趋势,临床用药宜选用泰能、三代头孢菌素或含有β-内酰胺酶抑制剂的β-内酰胺类抗生素。联合用药效果较好。

Objective To discover occurrence of drug resistance produced by Klebiisella pneumoniae and prevent its spreading as soon as possible. Methods Klebiisella pneumoniae were identified accurately to species with VITEKAMS system by applying GNI card. Review was performed to analyse the clinical symptom and drug resistance of the 328 patients infected by Klebiisella pneumoniae in lung. Results 93.8 % of 328 patients, had basic diseases, mostly chronic obstructive pulmonary disease. These patients presented symptoms of fever, sputum produced cough, X - ray of lobular consolidation in air inflated sign （ 28.2 % ）, infiltration in lung （ 53.4 % ） and lung absence （ 18.4 % ）. Its drug resistance is relatively high. Conclusions The incidence of atypical infection caused by klebisella pneumoniae was higher, so we should preferentially choose tienam, third generation of cephalosporin or antibiotics containing β- lactamase inhibitor. It can be better treated depending on combination.