摘要
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（KPN）in patients in intensive care unit（ICU）,so as to provide evidence for clinical infection control.METHODS A total of 551 strains of KPN isolated from ICU from Jan.2014 to Dec.2016 were selected,and pathogenic bacteria identification and drug susceptibility test were carried out.RESULTS The detection rates of KPN in ICU were 16.29%,14.56% and 15.25% in 2014-2016,respectively.The total detection rate was 15.35% in three years.The main specimens were from sputum and blood.The resistant rates of KPN to ampicillin,ceftriaxone,ampicillin sulbactam,aztreonam and ceftazidime were 99.82%,57.71%,56.81%,49.36% and 42.65%,with a decline trend,and the resistant rates to imipenem were 39.88%,33.55% and 17.32% in the three years,showing a significant decline.CONCLUSION The detection rate of KPN infection in ICU is not increased for the 3 consecutive years,and the drug resistant rate is decreased year by year.It is suggested to strengthen the monitoring of multidrug-resistant bacteria and the use management of antimicrobial agents,and choose sensitive antimicrobial agents according to drug susceptibility results to reduce the proliferation of KPN.
作者
张红芳
陈名霞
展冠军
潘纯
胡继梅
ZHANG Hong-fang CHEN Ming-xia ZHAN Guan-jun PAN Chun HU Ji-mei(Zhongda Hospital Affiliated to Southeast University, Nanjing, Jiangsu 210009, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第20期4561-4563,4571,共4页
Chinese Journal of Nosocomiology
基金
南京市药学会资助项目(2016YX009)
关键词
肺炎克雷伯菌
重症医学科
耐药性
抗感染
Klebsiella pneumoniae
Critical care medicine
Drug resistance
Antimicrobial agents
