摘要
目的 通过多角度分析本地区耐药碳青霉烯酶肺炎克雷伯菌(CRKP)的相关数据,了解其临床流行病学特征和耐药特点。方法 收集我院2017年1月至2021年9月临床分离的CRKP,对年龄、科室分布和样本类型进行分析,并从不同科室和不同年龄段多个角度分析其药敏结果。结果 CRKP在2021年的检出率从2020年的3.30%明显升高至2021年的12.23%,菌株有流行趋势;检出的疾病类型以呼吸系统疾病(41.71%)为主,其次为心脑血管疾病(18.59%);CRKP在2017年≤17岁(65.71%)是主要检出年龄段,但此后≥66岁年龄段的检出量逐年增加,2020年和2021年均高于50%,位居第一;呼吸道样本的菌株检出量最多(146株,73.37%),主要科室分布是成人及儿童ICU(74株,37.19%和24株,12.06%);CRKP在年龄段≥41岁,复方新诺明的耐药率较低(49.4%),其次为阿米卡星(54.5%和68.2%),≤17岁年龄段则是妥布霉素的耐药率最低(4.3%)。成人ICU耐药率最低是复方新诺明(47.3%),其次为阿米卡星(52.7%),儿童病区暂未发现妥布霉素耐药,阿米卡星的耐药率也不超过8.3%。结论 CRKP对氨基糖苷类抗菌药物和复方新诺明的敏感性较高,其次,对氟喹诺酮类药物的耐药率相对β内酰胺类药物较低,成人感染CRKP可首选复方新诺明抗感染,儿童可首选氨基糖苷类的妥布霉素及阿米卡星。
Objective To investigate clinical epidemiological characteristics and drug resistance characteristics of carbapenemase resistant Klebsiella pneumoniae(CRKP)by analyzing the relevant data of this region from multiple perspectives,so as to provide some basis for clinical rational drug use.Methods From January 2017 to September 2021,clinical isolates of CRKP in our hospital were collected.Age,department distribution and sample type were analyzed.Drug sensitivity results were analyzed from multiple perspectives of different departments and age groups.Results The detection rate of CRKP in 2021 increased significantly from 3.30%in 2020 to 12.23%in 2021,indicating an epidemic trend.The main diseases were respiratory diseases(41.71%),followed by cardiovascular and cerebrovascular diseases(18.59%).CRKP was mainly detected in the age group of≤17 years old(65.71%)in 2017,but since then,the detection of CRKP in the age group of≥66 years old has increased year by year,with an average annual rate of more than 50%in 2020 and 2021,ranking the first.The most strains were detected in respiratory samples(146 strains,73.37%),and the main departments were adult and child ICU(74 strains,37.19%and 24 strains,12.06%).The drug resistance rate of CRKP in the age group≥41 years old was low(49.4%),followed by amikacin(54.5%and 68.2%),and the drug resistance rate of tobramycin in the age group≤17 years old was the lowest(4.3%).The lowest drug resistance rate in adult ICU was cotrimoxazole(47.3%),followed by amikacin(52.7%).Tobramycin resistance was not found in children s ward,and drug resistance rate of amikacin was no more than 8.3%.Conclusion CRKP has higher sensitivity to aminoglycoside antibiotics and cotrimoxazole,and drug resistance rate to fluoroquinolones is lower than that ofβ-lactams.Cotrimoxazole could be the first choice for adults infected with CRKP,and tobramycin and amikacin could be the first choice for children.
作者
谢兴凤
刘小青
代春梅
蒋久怡
Xie Xingfeng;Liu Xiaoqing;Dai Chunmei(Departmant of Clinical Laboratory,Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang,Sichuan 621000,China)
出处
《四川医学》
CAS
2023年第3期279-284,共6页
Sichuan Medical Journal
基金
绵阳市中心医院孵化课题(编号:2019FH11)。
关键词
肺炎克雷伯菌
碳青霉烯酶
耐药性
Klebsiella pneumoniae
Carbapenemase
drug resistance
