血流感染肺炎克雷伯菌的临床分布及耐药性分析

Clinical distribution and drug resistance of Klebsiella pneumoniae for bloodstream infection

目的:了解山东第一医科大学第一附属医院血流感染肺炎克雷伯菌的临床分布及耐药特征,为临床抗感染治疗提供理论依据。方法:收集山东第一医科大学第一附属医院2017年~2019年引发血流感染的肺炎克雷伯菌菌株,使用MALDI-TOF MS进行菌种鉴定,应用纸片法进行药敏试验。结果:共分离到196株肺炎克雷伯菌,ICU病区及60岁以上的老年患者是主要的感染人群,男性患者人数要高于女性患者。除氨苄西林、头孢唑林及头孢噻肟外,其余抗生素的耐药率均在50%以下。但不同抗生素在不同年份表现出不同的变化规律。结论:ICU病区、老年患者及男性患者应该成为血流感染肺炎克雷伯菌的重点关注人群。鉴于本院血流感染肺炎克雷伯菌中多重耐药菌尤其是CRE菌株具有较高的分离率且不同抗生素的耐药率呈现不同变化趋势,临床上需要根据药敏结果合理用药。

Objective:To investigate the distribution and antibiotic resistance of Klebsiella pneumoniae isolated from blood and to provide basis for clinical anti-infection treatment.Methods:BSI K.pneumoniae isolates were collected from 2017 to 2020 and identified by MALDI-TOF MS.Antibiotic susceptibility tests were performed with disk diffusion method.Results:A total of 196 K.pneumoniae isolates were detected.Patients in ICU ward and over 60 years old were the main population.Besides,male was easier to infect K.pneumoniae than that of female patients.Except for ampicillin,cefazolin and cefotaxime,the resistance rates of other antibiotics were all below 50%.However,different antibiotics showed different changing trends in different years.Conclusion:More attention should be pay to elderly and male patients as well as the patients in ICU ward.Considering the high isolation rate of multi-drug resistant(especially the CRE strain)K.pneumoniae bacteria in bloodstream in this hospital and the changing trends of different antibiotics,it is necessary to promote rational medicine use according to the antibiotic sensitivity results.