343株感染患者肺炎克雷伯菌的分布及耐药性分析

Analysis on Clinical Distribution and Its Resistance of Klebsiella Pneumonia Isolated from Patient with Pulmonary Infection

目的:分析医院成人患者感染肺炎克雷伯菌的临床分布及其对抗菌药物的耐药性。方法:选取2015年1月—2017年12月间收治的患者经痰培养分离出肺炎克雷伯菌的343份病历,分析肺炎克雷伯菌的临床分布及其对抗菌药物的耐药性。结果:343株肺炎克雷伯菌中,发病人群主要集中在70~89年龄段,男性多见,分布的主要科室为重症医学科、呼吸内科及神经内科;所有菌株中多重耐药菌株占30.61%,各年检出率相当;产ESBL菌株占23.32%,呈逐年下降趋势;耐碳青霉烯类菌株占1.75%,2017年检出率低于2016年;肺炎克雷伯菌对目前临床常用的多种抗菌药物,如碳青酶烯类、氨基糖苷类、β-内酰胺类、头孢西丁以及头孢菌素类仍有较好的敏感性,其中对碳青酶烯类为最高。结论:上述研究结果对临床用药有一定的指导作用。

Objective： To analyze the clinical distribution and its resistance of Klebsiella pneumonia（KPN）that was isolated from adult patient with pulmonary infection in recent years.Methods： 343 medical records of KPN were isolated from patients admitted between January 2015 and December 2017 through sputum culture.The clinical distribution of KPN and its resistance to antimicrobial agents were analyzed.Results： A total of 343 KPN isolated from sputum in recent three years were collected,which was mainly concentrated on elder male from the age of 70 to 89 years old and on the departments of Intensive Care Unit（ICU）,Respiratory Medicine,as well as Neurology.On the other hand,the isolating rate of strains of multipled drug resistant was 30.61%,which,in three years,was almost the same.The rate of the extended spectrum β-lactamase（ESBL） producing strains was 23.32%,which proved a decline among these years.And the rate of carbapenem resistant strains were 1.75%,which were decreased in 2017 compared with in 2016.What＇s more,the KPN strains were sensitive to most clinically usedantimicrobial agents such as carbapenem,aminoglycosides,β-lactamase antibiotics,cefoxitin and cephalosporins,and the carbapenem was the most sensitive.Conclution：The results showed a certain guideline for our clinical medication.