论文部分内容阅读
目的:分析深圳市南山区人民医院7年来临床分离的耐碳青霉烯类肺炎克雷伯菌(CRKP)临床分布及耐药特点,为临床合理用药提供参考。方法:收集2010年1月至2016年12月本院临床分离的CRKP,分析标本来源、科室分布及耐药变迁。结果:1528株非重复分离的肺炎克雷伯菌中,检出CRKP 86株(5.63%)。2010年至2016年CRKP检出率分别为3.22%、2.22%、2.56%、4.87%、3.14%、12.92%、11.79%,呈逐年上升趋势。86株CRKP产超广谱β-内酰胺酶(ESBL)率为55.81%(48/86)。CRKP菌株主要来源于痰液(57.65%)及中段尿(20.00%),主要分布于重症监护病房(ICU)、普外科及呼吸内科。2010年至2016年CRKP对抗菌药物总耐药率最高的是氨苄西林(100%),其次是头孢唑林(94.44%)。耐药率最低的是阿米卡星(16.28%),其次是庆大霉素(24.42%)。而美罗培南和亚胺培南总耐药率分别是72.09%和82.56%,并呈逐年上升趋势。结论:CRKP感染呈逐年上升趋势,临床应实施严格的感染控制措施防止CRKP在医院内的快速传播。
Objective: To analyze the clinical distribution and drug resistance characteristics of carbapenem - resistant Klebsiella pneumonia (CRKP) isolated clinically in Shenzhen Nanshan People ’s Hospital for 7 years, and provide a reference for rational clinical use. Methods: The clinical isolates of CRKP collected from January 2010 to December 2016 in our hospital were collected. The source of specimens, distribution of departments and drug resistance were analyzed. Results: Of 1528 non-repetitive Klebsiella pneumoniae isolates, 86 strains of CRKP (5.63%) were detected. The detection rates of CRKP from 2010 to 2016 were 3.22%, 2.22%, 2.56%, 4.87%, 3.14%, 12.92% and 11.79% respectively, showing an increasing trend year by year. The 86 CRKP-producing ESBLs were 55.81% (48/86). The CRKP strains mainly originated from sputum (57.65%) and middle urine (20.00%), mainly distributed in intensive care unit (ICU), general surgery and respiratory medicine. From 2010 to 2016, the highest rate of total resistance to antibiotics in CRKP was ampicillin (100%), followed by cefazolin (94.44%). The lowest rates of resistance were amikacin (16.28%), followed by gentamicin (24.42%). The total drug resistance rates of meropenem and imipenem were 72.09% and 82.56%, respectively, showing an increasing trend year by year. Conclusion: The CRKP infection shows an upward trend year by year. In clinical practice, strict infection control measures should be implemented to prevent the rapid spread of CRKP in the hospital.