摘要
目的分析烧伤患者临床分离出的耐碳青霉烯类肺炎克雷伯菌(CRKP)耐药趋势及其耐药性,为烧伤感染患者临床合理用药提供依据。方法选2010年1月-2015年1月烧伤科收治的1 816例烧伤患者,共分离出耐碳青霉烯类抗菌药物肺炎克雷伯菌(CRKP)268株,分别采用美国碧迪Phoenix 100全自动细菌鉴定分析仪及KB纸片(扩散)法,测定菌株的药物敏感性,数据采用WHONET 5.6软件进行统计分析。结果 5年烧伤患者临床分离出CRKP 268株,检出率为14.8%;CRKP对氨曲南、头孢哌酮/舒巴坦、氨苄西林、头孢他啶、左氧氟沙星、庆大霉素及亚胺培南、美罗培南、厄他培南的耐药性逐年上升且与年份增加呈正相关(P<0.05),碳青霉烯类抗菌药物(亚胺培南、美罗培南)使用强度与CRKP检出率呈正相关(P<0.05)。结论烧伤创面CRKP检出率居烧伤病房首位,应加强烧伤创面处理以控制CRKP的播散。
OBJECTIVE To analyze the resistance trends of carbapenems-resistant Klebsiella pneumoniae（CRKP）isolates from burn patients and the drug resistance to commonly used antibiotics,so as to provide the basis for rational drug use in future.METHODS A total of 1 816 strains were isolated from the burn patients admitted in burn department from Jan.2010 to Jan.2015.There were 268 strains of carbapenems-resistant Klebsiella pneumoniae（CRKP）isolated from the microbial culture,and they were tested by USA Becton Dickinson Phoenix 100 automatic bacterial identification analyzer and K-B（disk diffusion）method.The drug resistance in recent 5years of different antibiotics on CRKP was analyzed by WHONET 5.6software.RESULTS Totally 268 strains of carbapenemresistant K.pneumoniae（CRKP）were isolated and the detection rate of the CRKP showed an upward trend in recent 5years（from 3.4per cent in 2010 rose 14.8%in 2014）.The drug resistance rates of CRKP to aztreonam,cefoperazone/sulbactam,ampicillin,ceftazidime,levofloxacin,gentamicin and imipenem,meropenem,and ertapenem were significantly increased and positively correlated with year（P〈0.05）.The detection rate of CRKP was positively correlated with the use intensity of the carbapenems including imipenem and meropenem（P〈0.05）.CONCLUSIONThe result shows that CRKP is the most infective pathogens in burn wounds and wound treatment should be strengthened to control the dissemination of CRKP.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第7期1474-1476,1488,共4页
Chinese Journal of Nosocomiology
基金
国家自然科学基金资助项目(81272112)
上海交通大学医学院科技基础基金资助项目(YZ1007)
关键词
烧伤
耐碳青霉烯类肺炎克雷伯菌
抗菌药物
耐药性
Burn
Carbapenems-resistant Klebsiella pneumoniae
Antibiotics
Drug resistance
