摘要
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 drug resistance tendency and clinical distribution characterisitics of clinically isolated carbapenem-resistant Klebsiella pneumoniae（CRKP）,and provide evidence for rational use of antimicrobial agent.Methods Collected from January 2010 to December 2016,the clinical separation of the hospital CRKP,analyze specimen source,department distribution and drug resistance changes.Results Of the 1528 strains of Klebsiella pneumoniae,86 strains（5.63%） of CRKP were detected.The detection rates of CRKP were 3.22%,2.22%,2.56%,4.87%,3.14%,12.92% and 11.79% respectively from 2010 to 2016,respectively.The rate of extended-spectrum β-lactamases（ESBL） of 86 CRKP was 55.81%（48/86）.CRKP strains were mainly derived from sputum（57.65%） and middle urine（20.00%）,mainly distributed in intensive care unit（ICU）,general surgery and respiratory medicine.Between 2010 and 2016,CRKP had the highest total antimicrobial resistance rate of ampicillin（100%）,followed by cefazolin（94.44%）.The lowest resistance rate was amikacin（16.28%）,followed by gentamicin（24.42%）.While the total resistance rates of meropenem and imipenem were 72.09% and 82.56%,respectively,and showed an increasing trend.ConclusionThe proportion of CRKP infection is increase year by year,clinical monitoring on CRKP should be strengthened,so as to prevent and control the spread and prevalence of CRKP.
作者
马孝煜
郑金鑫
林志伟
邓向斌
徐广健
孙翔
白冰
邓名贵
李多云
余治健
邓启文
MA Xiao-yu ZHENG Jin-xin LIN Zhi-wei DENG Xiang-bin XU Guang-jian SUN Xiang BAI Bin DENG Ming-gui LI Duo-yun YU Zhi-jian DENG Qi-wen(Shenzhen Nanshan District People＇s Hospital, Guangdong Shenzhen 518052)
出处
《深圳中西医结合杂志》
2017年第17期1-3,199,共4页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
基金
深圳市科技创新委资助课题(JCYJ20150402152130167
JCYJ20150402152130173)
深圳市卫人委课题资助课题(201601058)
深圳市南山区人民医院资助课题(2016010)
深圳市南山区资助课题(2015019
2015022
2016001
2016002
2016010
2016012
2016013
2016018
2016017)
深圳市重点学科和重点实验室建设经费资助课题(ZDSY20130402151000730)
关键词
肺炎克雷伯菌
耐碳青霉烯类肺炎克雷伯菌
细菌耐药性
Klebsiella pneumoniae
Carbapenem-resistant Klebsiella pneurnoniae
Bacterial drug resistance
