2015年～2016年肺炎克雷伯菌临床分布及耐药变迁性分析

Clinical Distribution and Drug Resistance of Klebsiella Pneumoniae from 2015 to 2016

目的:了解本医院2015年1月~2016年12月临床分离肺炎克雷伯菌分布特征及耐药变迁状况,为临床预防和控制感染提供依据.方法:采用VITEK2-compact微生物鉴定仪进行鉴定及药敏试验.用whonet 5.6软件进行数据统计分析。结果:2015年1月~2016年12月共检出肺炎克雷伯菌680株。临床标本主要来源于痰液占65.29%.药敏统计分析经2016年与2015年比较:头孢类耐药增长率提高了10%以上;喹诺酮类药物耐药增长率提高了15%以上;碳青霉烯类药物耐药增长率提高了20%,CREKPC比例占26.95%。ICU耐药率逐年上升非常明显:头孢类耐药增长率提高了20%以上,哌拉西林/他唑巴坦耐药增长率提高了50%以上;碳青霉烯类药物耐药增长率提高了50%,CRE-KPC比例占70.75%;喹诺酮类药物耐药增长率提高了近40%。ICU的耐药率明显高于与非ICU,尤其是头孢他啶、头孢吡肟、碳青霉烯类、喹诺酮类分别高出了70%、35.6%、60%、50%。结论:本医院肺炎克雷伯菌株以痰液居多,多数抗菌药物耐药率逐年提高,ICU的耐药率明显高于与非ICU,CRE比例增高明显,须高度重视。

Objective： To investigate the distribution characteristics and drug resistance of clinical isolates of Klebsiella pneumoniae in our hospital from January of 2015 to November of 2016, provide basis for clinical prevention and control of infection in. Methods： Identification and drug sensitivity test using VITEK2-compact microbial identification system. Statistical analysis using whonet5.6 soft- ware. Results： From January of 2015 to November of 2016, a total of 680 strains of Klebsiella pneumoniae were isolated in our hospi- tal. Most of the clinical samples come from sputum, which are accounted for 65. 29%. Comparative analysis of drug sensitivity in 2016 and 2015 ： the resistant growth rate of Cephalosporinare increased more than 10% ; The growth rate of quinolone resistance was in- creased by more than 15%, the resistant growth rate of carbapenems increased 20%, the proportion of CRE-KPC accounted for 26.95%. The resistance rate of ICU increased year by year is obvious： The growth rate of cephalosporin resistance increased by more than 20%, the growth rate of piperacillin/tazobactam increased by more than 50%, the growth rate of carbapenem resistance in- creased by 50%, and the proportion of CRE-KPC accounted for about 70.75% ; Quinolone drug resistance increased by nearly 40% ~ The drug resistance rate of ICU was significantly higher than that of non ICU, especially ceftazidime, cefepime, carbapenems and quinolones, which were more than 70%, more than 35. 6%, more than 60%, more than 50%. Conclusion： The majority of the strains of Klebsiella pneumoniae in our hospital were mostly sputum, and the drug resistance rate was increased year by year. The drug resistance rate of ICU was significantly higher than that of non ICU, and the proportion of CRE increased obviously.