一例复杂性多部位耐碳青霉烯类肺炎克雷伯菌感染病例并文献分析

A case of complex multisite carbapenem-resistant Klebsiella pneumoniae infection and literature analysis

目的:分析1例复杂性多部位耐碳青霉烯类肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP)感染的病例,探讨其治疗方案的合理性,为临床合理用药提供参考。方法:收集患者临床及检验资料,观察临床疗效,比较治疗前后检验指标及病原学检查结果,评估治疗效果并复习国内外相关文献。结果和结论:对该患者采用的治疗方案是美罗培南、阿米卡星联合磷霉素。通过检索文献发现,目前有多种针对CRKP感染的治疗方案可供临床选择,但治愈率尚不明确。重症监护病房(ICU)易出现CRKP流行,减少广谱抗菌药物的不合理使用及不必要的有创操作,是控制CRKP流行、减轻患者经济负担的有效措施。

Objective:To analyze a case of complex multisite carbapenems-resistant Klebsiella pneumoniae(CRKP)infection,and to evaluate the rationality of the treatment scheme,so as to provide reference for rational use of drugs.Methods:The clinical and laboratory data of the patient were collected,and the clinical efficacy was observed,laboratory indexes and the results of etiological examination were compared,treatment effect was evaluated and relevant literature was reviewed.Results and Conclusion:In the treatment of the patient,meropenem,amikacin combined with fosfomycin were used.Literature retrieval revealed that there were many kinds of antimicrobial therapy options for CRKP infection,but cure rate was not clear.The prevalence of CRKP was more feasible in the intensive care unit(ICU).Reducing irrational use of broad-spectrum antibacterials and unnecessary invasive manipulation were effective strategies for the control of CRKP prevalence and reduction of economic burden on patients.