摘要
目的了解医院肺炎克雷伯菌感染的流行特征及耐药性变迁情况。方法收集2015-2017年肺炎克雷伯菌分离株的临床资料,对检出情况、标本来源、科室分布及耐药性的变化趋势等进行分析。结果 2015年1月-2017年12月检出的1 407株肺炎克雷伯菌中,产ESBLs菌株占36. 67%。其中,秋冬季分别占29. 85%和39. 23%。标本来源以痰液为主,占47. 90%,其中脓液及分泌物标本来源逐年增加。科室分布以重症监护室较高,占36. 60%,外科占比呈现升高趋势。肺炎克雷伯菌对碳青酶烯类耐药率逐年降低,对头孢替坦、阿米卡星,β-内酰胺类/β-内酰胺酶等耐药率较低(<7. 2%),而对氨曲南、头孢菌素如头孢唑林、头孢曲松及头孢他定、左氧氟沙星等耐药率呈逐年增加趋势。结论肺炎克雷伯菌感染多发生于秋冬季,外科感染比例较高,其对头孢菌素类抗菌药物耐药率有升高趋势,应根据季节变化,加强对重点科室的耐药性监测,指导临床合理用药。
Objective To investigate the epidemiological characteristics and antibiotic resistance of Klebsiella pneumoniae in a hospital. Methods The clinical data of Klebsiella pneumoniae isolates were collected from 2015 to 2017. The analysis of the detection rate,specimens source,department distribution and change trend of resistance to antibacterila drugs was performed. Results Totally 1 407 strains of Klebsiella pneumoniae were isolated,of which 36. 67% were ESBLs-producing Klebsiella pneumoniae. It mostly occurred in autumn and winter,accounting for 29. 85% and 39. 23%,respectively. The main source of specimens was sputum,accounting for 47. 90%,of which the source of pus and secretions increased year by year. The department distribution was higher in intensive care units,accounting for 36. 60%,and the proportion of surgical departments was increasing. The resistance rate of Klebsiella pneumoniae to carbapenems was reducing year by year. The resistance rate of Klebsiella pneumoniae to cefotetan,Amikacin,beta lactam/beta lactamase was staying in a low level( < 7. 2%). However,the resistance rate of Klebsiella pneumoniae to aztreonam,cephalosporins such as cefazolin,ceftriaxone,ceftazidine,and levofloxacin was increasing year by year. Conclusion Klebsiella pneumoniae infection mostly occurred in the autumn and winter,and there was an upward trend of infection in surgical departments. The resistance rate of Klebsiella pneumoniae to cephalosporins was increased. The surveillance of drug resistance in key departments should be strengthened according to seasonal changes,in order to guide the drug use rationally in clinic.
作者
李元叶
冯燕
高晖
LI Yuan -ye;FENG Yah;GAO Hui(Jining First People's Hospital,Jining Shandong 272000,China)
出处
《中国消毒学杂志》
CAS
2018年第12期925-927,930,共4页
Chinese Journal of Disinfection
关键词
肺炎克雷伯菌
流行特征
耐药性监测
Klebsiella pneumoniae
epidemiological characteristics
drug resistance surveillance
