新生儿耐碳青霉烯类肺炎克雷伯菌感染的防治进展

Update on the prevention and treatment of neonatal Carbapenem-resistant Klebsiella pneumoniae

近年来,广谱抗生素在临床中的大量应用导致耐碳青霉烯类肺炎克雷伯菌(CrKP)在新生儿重症监护病房的检出率逐年增高。新生儿感染CrKP通常缺乏特异性临床表现,易引发菌血症、脑膜炎、腹腔感染等疾病,甚至严重危及患儿生命。碳青霉烯类抗生素联合头孢他啶-阿维巴坦、替加环素、多菌素等新型药物抗感染是目前治疗新生儿CrKP感染的有效方案。除合理用药外,还需严格执行抗菌药物管理及医院感染防控措施,以减少CrKP在新生儿病房的定植与传播。

In recent years,the use of broad-spectrum antibiotics in clinical practice has led to an increase in the detection of Carbapenem-resistant Klebsiella pneumoniae(CrKP)in neonatal intensive care units.CrKP infection in newborns usually lacks specific clinical manifestations and can lead to bacteremia,meningitis and abdominal infections,which can be life-threatening.Combination of carbapenem antibiotics or newer drugs such as ceftazidime/avibactam,tigecycline and polymyxin are currently effective treatment options for CrKP infection in neonates.In addition to rational drug use,strict antimicrobial stewardship,hospital infection prevention and control measures are needed to reduce the colonisation and spread of CrKP in the neonatal ward.