2018—2021年中江县人民医院肺炎克雷伯菌临床分布及耐药变迁

Clinical Distribution and Drug Resistance Changes of Klebsiella Pneumoniae in Zhongjiang County People's Hospital From 2018 to 2021

目的:动态监测2018—2021年中江县人民医院临床分离的肺炎克雷伯菌(KP)株数及耐药性变迁情况,分析其流行病学情况,评估其耐药性的变化。方法:收集中江县人民医院2018年1月—2021年12月临床分离的非重复KP,采用Micro Scan Walk Away 40Plus全自动微生物鉴定及药敏仪进行菌种鉴定和药敏试验,使用WHONET5.6软件对药敏结果进行统计分析。结果:2018年1月—2021年12月,共分离出KP 1848株,其中2018年417株,2019年445株,2020年479株,2021年507株,菌株数呈逐年增加趋势。检出菌株数较多的科室为重症监护室(占13.4%)、胸外神经外科(占11.3%)、呼吸内科(占10.1%)。标本类型分布前3位分别为痰液、尿液和分泌物。从年龄分布来看,>65岁的患者人数最多,7~18岁的患者人数最少。在耐药性方面,KP对头孢类药物的耐药率>24.0%,对厄他培南的耐药率<1.0%,对大部分抗菌药物的耐药率<20.0%。结论:2018—2021年KP对大多数常见抗菌药物的耐药率呈现稳中有降的变化趋势,但仍需持续监测分离株的药物敏感性,以指导临床用药。

Objective:To dynamically monitor the number of Klebsiella pneumoniae(KP)clinical isolates and drug resistance changes in Zhongjiang County People′s Hospital between 2018 and 2021,analyze the epidemiology and assess the changes in drug resistance.Methods:Nonrepetitive KP clinically isolated in Zhongjiang County People′s Hospital from January 2018 to December 2021 were collected.The bacterial species identification and drug sensitivity test were performed by MicroScan WalkAway 40Plus automatic microbial identification and drug sensitivity analyzer.The drug sensitivity results were statistically analyzed by WHONET5.6 software.Results:Between January 2018 and December 2021,a total of 1848 KP strains were isolated,including 417 strains in 2018,445 strains in 2019,479 strains in 2020,and 507 strains in 2021.The number of strains showed an annual increasing trend.The departments with a higher number of strains detected were intensive care unit(13.4%),thoracic neurosurgery department(11.3%)and respiratory medicine department(10.1%).The top three types of specimens were sputum,urine and secretions.In terms of age distribution,the number of patients aged>65 years was the highest,and the number of patients aged 7-18 years was the lowest.In terms of drug resistance,the resistance rate of KP to cephalosporins was>24.0%,and the resistance rate to ertapenem was<1%,and the resistance rate to the majority of antibacterials was<20.0%.Conclusion:The resistance rate of KP the majority of antibacterials from 2018 to 2021 is stable and decreased,but the drug sensitivity of isolates still needs to be monitored continuously,so as to guide clinical medication.