重症创伤患者肺炎克雷伯菌感染临床分布与耐药分析

Clinical distribution and drug resistance of Klebsiella pneumoniae infection in severe trauma patients

目的了解重症创伤患者肺炎克雷伯菌感染的临床分布及其耐药性,为临床合理用药供参考。方法通过回顾性分析方法,对某医院重症监护病房(ICU)住院严重创伤患者送检病原学标本检验结果进行调查与分析。结果从该医院ICU住院重症创伤患者送检标本分离的4 810株病原菌中,统计出肺炎克雷伯菌为533株,占分离细菌的11.08%。在分离的533株肺炎克雷伯菌中,有161株分离自严重创伤感染患者送检标本,主要分离自痰液和尿液标本。感染患者分离的肺炎克雷伯菌对临床常用抗菌药物耐药率呈逐年升高趋势,其中对氨苄西林、氨苄西林/舒巴坦、呋喃妥因、头孢唑啉的耐药率均达到100%。结论该医院住院重症创伤患者肺炎克雷伯菌感染部位主要是呼吸道和尿路感染,对常用抗菌药物耐药率较高,加强消毒隔离措施和合理使用抗菌药物为重点防控措施。

Objective To understand the clinical distribution and drug resistance of Klebsiella pneumoniae infection in severe trauma patients,and to provide reference for clinical rational drug use. Methods Retrospective analysis method was used to investigate and analyze the test results of hospital pathogen of censorship patients with severe trauma in intensive care unit（ ICU） of a hospital. Results Of 4 810 strains of pathogenic bacteria isolated from specimens of ICU hospitalized severe trauma,533 strains were Klebsiella pneumoniae,which accounted for 11. 08%. Of them 161 strains were isolated from severe trauma infection patients,and mainly isolated from sputum and urine specimens. The resistance rate of Klebsiella pneumoniae from patients to clinical antimicrobial is increased year by year,the resistant rate to ampicillin,ampicillin / sulbactam and nitrofurantoin resistance,cefazolin were 100%. Conclusion The hospital hospitalization pneumonia in severe trauma patients Klebsiella,main infection sites were respiratory tract and urinary tract infection,the resistance rate to commonly used antimicrobial drug is high. Strengthen disinfection and isolation measures and rational use of antimicrobial agents were the key prevention and control measures.