肺结核伴肺炎克雷伯菌感染患者情况和耐药分析

Analysis of drug resistance of pulmonary tuberculosis patients complicated with Klebsiella pneumoniae infection

目的了解本院肺结核患者肺炎克雷伯菌的感染情况和耐药性。方法收集经临床确诊为肺结核伴有肺炎克雷伯菌感染患者中分离出肺炎克雷伯菌的药敏数据,并对其耐药情况进行回顾性分析。结果 587株肺炎克雷伯菌检出241株产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌,检出率为41.1%,这三年的ESBLs肺炎克雷伯菌的检出率是逐年增高的,依次为36.9%,43.1%,43.3%。检出人群中以≤20岁和≥60岁年龄段所占的比例最高,产ESBLs肺炎克雷伯菌耐药性要高于非产ESBLs肺炎克雷伯菌,对头孢一代、二代、三代耐药,但对亚胺培南、美罗培南、头孢哌酮/舒巴坦保持高度敏感。结论应加强肺炎克雷伯菌耐药监测,以指导合理用药减少耐药菌的发生和医院感染。

Objective To understand the drug resistance of pulmonary tuberculosis patients complicated with Klebsiella pneumoniae infection. Methods The clinical data of pulmonary tuberculosis patients accompanied with Klebsiella pneumoniae infection were collected to analyze its drug resistance situation. Results There were 241 strains of ESBLs detected in 587 strains of pneumonia Klebsiella bacteria, and the detection rate was 41.1% , which increased year by year during last 3 years （36.9% , 43.1%, 43.3% ）. Patients younger than 20 and older than 60 years old took the largest proportion. The drug resistance of producing ESBLs Klebsiella pneumonia was higher than non-producing ESBLs Klebsiella pneumonia. It was resistant to the first, second and third generation cephalosporin, but highly sensitive to imipenem, Meropenem, and cefoperazone/sulbactam. Conclusion The monitoring of Klebsiella pneumoniae resistance should be strengthened to guide the rational use of drugs to reduce the occurrence of drug-resistant bacteria and hospital infection.