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目的探讨重症医学科(ICU)患者肺炎克雷伯菌(KPN)感染的分布及耐药趋势,为临床感染控制及用药提供依据。方法选取2014年1月-2016年12月医院ICU分离出的551株KPN,并进行病原菌鉴定及药敏试验。结果 2014-2016年ICU KPN检出率分别为16.29%、14.56%、15.25%,合计3年检出率15.35%;主要标本来源于痰液和血液;肺炎克雷伯菌对氨苄西林、头孢曲松、氨苄西林舒巴坦、氨曲南、头孢他啶耐药率较高,分别是99.82%、57.71%、56.81%、49.36%、42.65%,但呈下降趋势,对亚胺培南耐药率分别是39.88%、33.55%、17.32%,呈明显下降。结论连续3年ICU感染KPN检出率无上升,耐药率呈逐年下降趋势;建议加强多药耐药菌监测、抗菌药物使用管理,针对药敏结果选用敏感性强的抗菌药物对降低KPN扩散有重要作用。
Objective To investigate the distribution and drug resistance of Klebsiella pneumoniae in patients with intensive care unit (ICU) and provide basis for clinical infection control and medication. Methods 551 KPN isolated from the hospital ICU from January 2014 to December 2016 were selected and pathogen identification and drug sensitivity test were conducted. Results The detection rates of ICU KPN in ICU from 2014 to 2016 were 16.29%, 14.56% and 15.25%, respectively, and the total detection rate was 15.35% in 3 years. The main specimens were sputum and blood. Klebsiella pneumoniae was sensitive to ampicillin and cefotaxime The rates of resistance to ampicillin, sulbactam, aztreonam and ceftazidime were high, which were 99.82%, 57.71%, 56.81%, 49.36% and 42.65%, respectively, but showed a decreasing trend. The rates of resistance to imipenem were Is 39.88%, 33.55%, 17.32%, was significantly decreased. CONCLUSION: The detection rate of KPN infection in ICU has not increased for 3 consecutive years and the drug resistance rate has been declining year by year. It is suggested to strengthen the monitoring of multidrug-resistant bacteria and the administration of antibacterial drugs, and to select antimicrobial agents with high sensitivity to reduce the proliferation of KPN Have an important role.