肺炎克雷伯菌感染抗菌药物应用研究

Use of antibiotics for treatment of Klebsiella pneumoniae infection

目的分析医院肺炎克雷伯菌感染抗菌药物使用及其耐药性,指导临床对肺炎克雷伯菌引起的感染合理用药。方法 2014年6月在微生物检测结果基础上,查阅病历对某医院2011-2013年感染肺炎克雷伯菌及耐药性进行统计分析。结果由肺炎克雷伯菌导致的感染患者223例,感染部位以下呼吸道、血液、泌尿道较高,分别占49.78%、23.32%、7.17%;碳青霉烯类、喹诺酮类、青霉素+酶抑制剂类抗菌药物使用率较高,依次为29.60%、21.52%、18.83%;肺炎克雷伯菌对哌拉西林、头孢噻肟、头孢呋辛、庆大霉素及环丙沙星耐药率最高,分别为61.0%、57.4%、55.2%、49.8%及38.6%;对碳青霉烯类抗菌药物亚胺培南和美罗培南耐药率分别为3.4%和5.4%。结论针对肺炎克雷伯菌引起的感染应注意合理使用抗菌药物,防止耐药菌的发生。

OBJECTIVE To investigate the use of antibiotics for treatment of hospital-associated infection due to Klebsiella pneumoniae and analyze the drug resistance so as to provide guidance for reasonable use of antibiotics for clinical treatment of the K.pneumoniaeinfection.METHODS The medical records were reviewed on the basis of results of the microbiological examination in Jun,2014.The distribution of the K.pneumoniae infection and the drug resistance were statistically analyzed from 2011 to 2013.RESULTS Of the 223 patients with K.pneumoniae infection,49.78% had the lower respiratory tract infections,23.32% had the blood infections,and 7.17% had urinary tract infection.The utilization rates of carbapenems,quinolones,and penicillin plus enzyme inhibitors were29.60%,21.52%,and 18.83%,respectively.The drug resistance rates of the K.pneumoniaeto piperacillin,cefotaxime,cefuroxime,gentimicin,and ciprofloxacin were 61.0%,57.4%,55.2%,49.8%,and 38.6%,respectively;the drug resistance rates to carbapenems such as imipenem and meropenem were 3.4% and 5.4%,respectively.CONCLUSION It is necessary to pay attention to the reasonable use of antibiotics for the treatment of the K.pneumoniaeinfection so as to prevent the emergence of drug-resistant strains.