烧伤患者抗碳青霉烯类抗生素肺炎克雷伯菌感染的再认识及抗菌治疗策略

Further understanding of infection of carbapenems-resistant Klebsiella pneumoniae among burn patients and the related strategies for antimicrobial treatment

抗碳青霉烯类抗生素肺炎克雷伯菌（CRKP）在烧伤病房的检出及流行，已成为烧伤抗感染治疗中十分棘手的问题。因此，有必要进一步认识CRKP感染的流行病学、易感因素、临床特征及治疗策略。应用药代动力学和药效学理论，制订CRKP感染时抗菌治疗及联合用药的原则、实施恰当的剂量策略，显得尤为重要。治疗CRKP感染常用抗菌药物包括多黏菌素、替加环素、磷霉素和碳青霉烯类抗生素。为有效地抑制和防止CRKP的传播，感染控制管理措施中必须整合接触隔离、主动筛选和环境消毒。

The prevalence of carbapenems-resistant Klebsiella pneumoniae （CRKP） in burn wards has become one of the most troublesome issues in current management of bacteri-al infections. It is necessary for us to reconsider the epidemiolo-gy, risk factors and clinical characteristics of CRKP infection as well as therapeutic options. Formulating the principles of antimi-crobial therapy of CRKP infection and combined antibiotics ther- apy and implementing appropriate dosage regimens designed by pharmaeokinetic and pharmaeodynamic profiles will be of impor-tance. Common antimierobial agents for the treatment of CRKP infection include polymyxins, tigecycline, fosfomycin, and car-bapenems. Infection control measures such as contact isolation, active screening, and environmental surface disinfection must be integrated with antimicrobial stewardship to effectively curb and prevent the spread of CRKP.