产碳青霉烯酶肺炎克雷伯菌血流感染患者的临床分析

Clinical features of bloodstream infections caused by carbapenemase-producing Klebsiella pneumoniae

目的对医院血培养产碳青霉烯酶肺炎克雷伯菌感染患者进行临床资料分析,对高危因素和治疗经验进行总结,给以后临床用药提供经验指导。方法回顾性分析医院2014年1月-2015年8月期间血培养产碳青霉烯酶肺炎克雷伯菌感染患者15例,对临床资料包括年龄、性别、原发病、入院时的APACHⅡ评分、是否有静脉导管、前期抗菌药物使用、是否激素使用,以及治疗经过等统计总结。结果 15例患者中,死亡7例,死亡率46.7%,治疗中替加环素+泰能效果较好,成功率为66.7%。结论对于广谱抗菌药物的使用、深静脉置管、呼吸机支持以及其他部位培养到产碳青霉烯酶肺炎克雷伯菌的患者容易发生血流感染,死亡率仍较高,治疗上替加环素+泰能效果较好。

OBJECTIVE To investigate the clinical data of patients with infections caused by blood-cultured carbap- enemase-producing Klebsiella pneumoniae and summarize the high-risk factors and treatment experience so as to provide guidance for clinical use of antibiotics. METHODS The clinical data of 15 patients with infections caused by blood-cultured carbapenemase-producing K. pneurnoniae who were treated in the hospital from Jan 2014 to Aug 2015 were retrospectively analyzed, including the age, genders, primary diseases, APACH Ⅱ scores at the admis- sion to hospital, use of venous catheters, early use of antibiotics, use of cortisol hormones, and treatment process. RESULTS Of the 15 patients, 7 died, with the mortality rate 46.7%. The tigecycline combined with tien- am could achieve significant curative effect, with the success rate 66.7%. CONCLUSION The risk factors for the bloodstream infections caused by the carbapenemase-producing K. pneumoniae include the use of broad spectrum of antibiotics, deep venous catheter indwelling, and ventilator supporting treatment, the mortality rate remains high, and tigecycline combined with tienam can achieve significant curative effect.