摘要
目的了解住院患者胆汁分离肺炎克雷伯菌(Klebsiella pneumoniae,KP)的耐药状况。方法收集2005年—2021年绍兴市人民医院住院患者胆汁分离的KP,并根据年度及年龄分组统计药敏结果及分析产超广谱β内酰胺酶、多重耐药、耐碳青霉烯酶菌株状况。结果共收集非重复KP 994株,占胆汁所有分离菌株的13.75%。随着年度和患者年龄的增加,胆汁KP占胆汁细菌构成比均呈一定下降趋势,对哌拉西林、头孢曲松、头孢哌酮/舒巴坦、呋喃妥因、碳青霉烯类的不敏感率呈上升趋势。对喹诺酮类、替加环素的不敏感率在年龄组间无明显变化趋势。对丁胺卡那霉素的不敏感率在年度和年龄组间均呈下降趋势。ESBL-KP、MDR-KP的总检出率分别为30.99%、62.88%,在年龄组间呈上升趋势。CR-KP的总检出率为5.94%,在年度和年龄组间均呈上升趋势。结论胆汁分离KP对主要抗菌药物的不敏感率呈上升趋势,不同年龄的人群存在差别,CR-KP分离率升高明显。
Objective To investigate the antimicrobial resistance of Klebsiella pneumoniae(KP)isolated from bile specimens of inpatients.Methods Klebsiella pneumoniae strains isolated from the bile specimens of inpatients in Shaoxing People’s Hospital from 2005 to 2021 were collected and classified by year and age;the results of drug non-susceptible rate,and producing extended-spectrum beta-lactamase,multi-drug resistance and carbapenem-resistant strains were analyzed.Results A total of 994 non-repetitive KP strains were collected,accounting for 13.75%of all isolated strains from bile specimens.With the increase of year and age of patients,the proportion of bile KP was decreased,and the insensitive rate to piperacillin,ceftriaxone,cefoperazone/sulbactam,nitrofurantoin and carbapenem were increased significantly,while the non-susceptible rate to amikacin was decreased significantly.The rate of insensitivity to quinolones and tigecycline had no significant change trend with year and age.The mean isolation rate of multidrug resistant Klebsiella pneumoniae(ESBL-KP),MDR-KP and carbapenem-resistant Klebsiella pneumoniae(CR-KP)was 30.99%,62.88%,and 5.94%respectively,and the detection rate increased significantly with age.In addition,the separation rate of CR-KP increased significantly with age.Conclusion The non-susceptible rate of KP in bile specimens was on the rise,and there was difference among people of different ages.The separation rate of CR-KP increased significantly.
作者
周清波
何强
李明晖
阮永春
鲁茵贇
周宜庆
ZHOU Qing-bo;HE Qiang;LI Ming-hui;RUAN Yong-chun;LU Yin-yun;ZHOU Yi-qing(Graduate School,Zhejiang Chinese Medical University,Hangzhou,Zhejiang 310053,China;不详)
出处
《中国卫生检验杂志》
CAS
2022年第17期2049-2056,共8页
Chinese Journal of Health Laboratory Technology
基金
浙江省卫生健康科技计划项目(2021KY1138,2021RC-134)
绍兴市科技计划项目(2018C30101,2020A13-029)
绍兴市人民医院青年科研基金项目(2020YB08)。
关键词
肺炎克雷伯菌
胆道感染
不敏感性
多重耐药肺炎克雷伯菌
碳青霉烯类耐药肺炎克雷伯菌
Klebsiella pneumonia
Biliary tract infection
Non-susceptible
Multidrug resistant Klebsiella pneumoniae
Carbapenem-resistant Klebsiella pneumoniae
