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目的分析肺炎克雷伯菌(KPN)的耐药性特征。方法采用Vitek-2Compact全自动微生物系统鉴定菌种及药敏分析仪对临床分离菌进行鉴定和药敏分析,同时检测超广谱β内酰胺酶(ESBLs),分析不同药物在KPN整体耐药性中的影响。结果 91株KPN血流感染,感染途径依次为呼吸道感染32例(35.2%),深静脉置管11例(12.1%),肝脓肿10例(11.0%)。KPN对氨苄西林、头孢噻肟和复方新诺明的耐药率依次为87.9%、45.1%和42.8%。对KPN不同药物的耐药性进行赋值评分与Cox危险回归分析显示,庆大霉素、氨苄西林、头孢唑林、亚胺培南、复方新诺明、头孢他啶及哌拉西林/他唑巴坦对KPN的整体耐药性影响最为显著(P<0.01);累积生存函数曲线分析显示,耐药危险性随着耐药积分增加而增加。结论鉴于KPN耐药性不断增加的复杂性,在临床经验用药前应当对其耐药性进行精准评估,根据实际情况合理选择抗菌药,从而减少耐药菌株的出现,提高感染的临床治愈率,改善患者预后。
Objective To analyze the drug resistance of Klebsiella pneumoniae (KPN). Methods The clinical isolates were identified and drug susceptible by Vitek-2 Compact automated microbial identification system and drug susceptibility analyzer. At the same time, the detection of ESBLs was carried out. The differences in the overall drug resistance of KPN In the impact. Results Totally 91 KPN patients were infected by bloodstream, followed by 32 cases of respiratory tract infection (35.2%), 11 cases of deep vein catheterization (12.1%) and 10 cases of hepatic abscess (11.0%). The resistance rates of KPN to ampicillin, cefotaxime and cotrimoxazole were 87.9%, 45.1% and 42.8%, respectively. Evaluation of resistance to different KPN drugs and Cox hazard regression analysis showed that gentamicin, ampicillin, cefazolin, imipenem, cotrimoxazole, ceftazidime and piperacillin / tazobactam The overall resistance to KPN had the most significant effect (P <0.01). The cumulative survival curve showed that the resistance risk increased with the increase of drug resistance. Conclusions In view of the increasing complexity of KPN drug resistance, its drug resistance should be evaluated accurately before clinical experience. Antibiotic drugs should be selected reasonably according to the actual situation so as to reduce the emergence of drug-resistant strains and improve the clinical cure rate of infection. Improve patient’s prognosis.