枣庄地区某医院肺炎克雷伯菌临床分离株的耐药性分析

Analysis on Drug Resistance of Klebsiella pneumoniae in a Hospital in Zaozhuang City

目的:回顾性分析2019年1月-2022年12月从枣庄市立医院住院患者分离肺炎克雷伯菌的耐药情况,为治疗耐碳青霉烯类肺炎克雷伯菌感染患者精准用药提供依据.方法:选择2019年1月-2022年12月枣庄市立医院所有感染肺炎克雷伯菌住院患者作为研究对象,分析肺炎克雷伯菌的科室分布特征、标本类型分布特征、抗菌药物耐药情况.结果:肺炎克雷伯菌分离率从升高到平稳发展,主要分布于重症监护室(57.01%),标本来源以呼吸道标本为主,分别为痰液(68%)和支气管肺泡灌洗液(12.33%),大部分抗菌药物耐药率都有明显降低,厄他培南和阿莫西林克拉维酸耐药率2019年最低,后面三年升高显著.结论:肺炎克雷伯菌一直有较高分离率,且2022年有上升趋势,耐碳青霉烯类肺炎克雷伯菌感染增加病人死亡风险,应加强抗菌药物分级管理,加大抗菌药物监测力度,给临床精准用药提供依据.

Objective:To retrospectively analyze the drug resistance of Klebsiella pneumoniae isolated from inpatients of Zaozhuang Municipal Hospital from January 2019 to December 2022,so as to provide evidence for the treatment of the carbapenem-resistant Klebsiella pneumoniae infection patients with precision medicine.Methods:All inpatients infected with Klebsiella pneumoniae in Zaozhuang Municipal Hospital from January 2019 to December 2022 were selected as the study objects.The distribution of departments,specimen types and antimicrobial resistance ofKlebsiella pneumoniae were analyzed.Results:The isolation rate ofKlebsilla pneumoniae showed the increasing from 57.01%to stable development,mainly distributed in the intensive care units(ICU).The specimens were mainly from respiratory specimens,including sputum(68%)and bronchoalveolar lavage fluid(12.33%),and the resistance rate of most antibiotics was significantly reduced.The resistance rates of Ertapenem and Amoxicillin clavulanate were the lowest in 2019,and increased significantly in the following three years.Conclusion:Klebsiella pneumoniae has always had a high isolation rate,and there was a rising trend in 2022.Carbapenem-resistant Klebsiella pneumoniae infection increases the risk of death in patients.It is necessary to strengthen the classification management of antibiotics and strengthen the monitoring of antibiotics,so as to provide precision drug use in clinic.