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目的:分析我院耐碳青霉烯类肺炎克雷伯菌感染患者的耐药趋势及预后情况。方法方法:借助医院感染实时监控系统收集2014年1—6月将首次院内发生肺炎克雷伯菌感染的资料,对病死率,呼吸机使用天数,中心静脉插管天数,尿道插管天数进行分析。结果结果:标本构成以痰中分离耐碳青酶烯类肺炎克雷伯菌居首位,占87.09%。标本以内科监护居首位35.48%,重症医学科次之32.25%。31株肺炎克雷伯菌株对美罗培南、亚胺培南的耐药率分别为48.39%、77.42%。耐碳青酶烯类肺炎克雷伯菌31例,平均住院(32.74±29.46)天,平均使用呼吸机(12.87±22.54)天,平均中心静脉插管(21.94±26.69)天,平均尿道插管(18.96±27.12)天。好转17例(54.84%),死亡14例(45.16%)。其中内科监护病房11例中死亡6例,病死率54.55%;重症医学科10例中死亡5例,病死率50.00%。结论结论:严格的消毒隔离措施,从而减少医院内感染,及时有效地细菌培养鉴定及药物敏感试验,尽早发现肺炎克雷伯菌的感染情况,严格有效的抗菌药物使用,为临床提供可靠的治疗依据。
Objective: To analyze the drug resistance and prognosis of carbapenem-resistant Klebsiella pneumoniae in our hospital. Methods and Methods: The data of the first hospital-acquired Klebsiella pneumoniae infection in January-June 2014 were collected with the help of real-time monitoring system for nosocomial infections. The mortality, the number of ventilator days, the number of catheterization days and the number of urethral catheterization were analyzed . Results Results: The specimens consisted of 87.09% isolates of Klebsiella pneumoniae isolated from sputum. The specimens were the first with 35.48% medical supervision and the second with 32.25%. The resistance rates of 31 strains of Klebsiella pneumoniae to meropenem and imipenem were 48.39% and 77.42%, respectively. Among the 31 patients with Klebsiella pneumoniae resistant to carbapenem, the mean hospital stay (32.74 ± 29.46) days was 12.87 ± 22.54 days on average and 21.94 ± 26.69 days on average. The average urethral intubation (18.96 ± 27.12) days. 17 cases improved (54.84%), 14 cases died (45.16%). Among them, 6 cases died of internal medicine ward in 11 cases and the case fatality rate was 54.55%. Among them, 5 cases were dead in 10 cases and the case fatality rate was 50.00%. Conclusions: Strict disinfection and isolation measures to reduce nosocomial infections, timely identification of bacterial culture and drug susceptibility testing, early detection of Klebsiella pneumoniae infection, strict and effective use of antimicrobial agents, provide a reliable clinical treatment in accordance with.