摘要
目的了解我院耐碳青霉烯类肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP)的临床分布特点及耐药性,为控制耐碳青霉烯类肺炎克雷伯菌的院内传播及临床治疗提供实验室依据。方法2016~2020年共收集118株耐碳青霉烯类肺炎克雷伯菌,用法国梅里埃公司VITEK 2 compact自动细菌鉴定/药敏系统进行试验;运用Whonet 5.6软件分析菌株耐药性。结果2016~2020共5年间CRKP检出率总体逐年增高;标本来源主要为痰及肺泡灌洗液等呼吸道标本,其次为分泌物、血液、中段尿等;CRKP检出的前五位科室分别为ICU、老年病、呼吸科、康复和胃肠外科;CRKP对18种临床常用抗生素广泛耐药;CRKP检出率与碳青霉烯类抗菌药物的用药频度(defined daily dose system,DDDs)呈正相关。结论耐碳青霉烯类肺炎克雷伯菌检出率逐年升高,以呼吸道标本为主,对临床常见抗菌药物广泛耐药,仅对替加环素保持较高敏感性;耐碳青霉烯类肺炎克雷伯菌检出率与碳青霉烯类DDDs呈正相关,应对碳青霉烯类抗菌药物进行宏观调控。
Objective To investigate the clinical distribution characteristics and drug resistance of carbapenem-resistant Klebsiella pneumoniae in our hospital and to provide a laboratory reference basis for controlling the nosocomial transmission and improve clinical treatment of carbapenem-resistant Klebsiella pneumoniae,Methods A total of 118 carbapenem-resistant strains of Klebsiella pneumoniae were collected from 2016 to 2020 and tested by VITEK 2 Compact automatic bacterial identification/drug sensitivity system of French biomerieux company.The drug resistance was analyzed by Whonet 5.6 software.Results The detection rate of CRKP increased yearly from 2016 to 2020.The main sources of specimens were respiratory tract specimens,such as sputum and bronchoalveolar lavage fluid,followed by secretions,blood and mid-stream urine.The top five departments detected by CRKP were ICU,Geriatrics,Respiratory,Rehabilitation and Gastrointestinal Surgery.CRKP was widely resistant to 18 types of antibiotics commonly used in clinical.The detection rate of CRKP was positively correlated with DDDs of carbapenems.Conclusion The detection rate of carbapenem-resistant Klebsiella pneumoniae increases yearly,mainly in respiratory tract specimens,and it is widely resistant to common antibiotics in clinic,but is highly sensitive to tigecycline,The detection rate of carbapenem-resistant Klebsiella pneumoniae is positively correlated with carbapenem-resistant DDDs,and carbapenem-resistant antibiotics should be macro-regulated.
作者
李玉雪
郭玉梅
陈学敏
赵俭
宋国威
安翠平
LI Yuxue;GUO Yumei;CHEN Xuemin;ZHAO Jian;SONG Guowei;AN Cuiping(Shijiazhuang People’s Hospital,Shijiazhuang 050011,China;Shijiazhuang Center for Disease Control and Prevention,Shijiazhuang 050000,China;Shijiazhuang Yanzhao Hospital,Shijiazhuang 050035,China)
出处
《标记免疫分析与临床》
CAS
2022年第8期1303-1307,共5页
Labeled Immunoassays and Clinical Medicine
基金
河北省医学科学研究课题计划(编号:20201397)。
