某院近5年耐碳青霉烯类肺炎克雷伯菌检出情况
Analysis on the Detection of Carbapenem-Resistant Klebsiella Pneumonia in a Hospital in Recent 5 Years
-
摘要: 目的 了解临床分离耐碳青霉烯类肺炎克雷伯菌 (CRKP) 检出情况, 提出药物治疗策略, 为CRKP医院感染的治疗及预防提供依据.方法 收集某医院2013年至2017年住院患者临床分离的CRKP, 分析其检出率及标本来源分布.结果 2 237株肺炎克雷伯菌中, 检出CRKP 76株 (3.40%) .2013年至2017年CRKP检出率呈逐年上升趋势, 差异有统计学意义 (P<0.01) .CRKP检出率与碳青霉烯类DDDS呈正相关, 差异有统计学意义 (P<0.01) .CRKP感染部位主要为呼吸道和泌尿道, 主要分布于ICU、神经外科和老年医学科.结论CRKP检出率逐年上升, 应引起临床及感控的高度重视.治疗方案多以替加环素或多黏菌素为基础的联合用药.
-
关键词:
- 耐碳青霉烯类肺炎克雷伯菌 /
- 检出情况 /
- 治疗策略
Abstract: Objective To understand the detection of clinically isolated carbapenem-resistant Klebsiella pneumonia (CRKP) , and propose a strategy for drug treatment, so as to provide evidence for treatment and prevention of CRKP nosocomial infections.Me thods The isolated CRKP specimens from inpatients from 2013 to2017 were collected in a local hospital. Detection rate and sources of specimens were analyzed. Re s ults Totally2, 237 strains of Klebsiella pneumonia were detected, and 76 (accounting for 3.40%) were CRKP strains. The detection rate of CRKP from 2013 to 2017 showed an upward trend gradually, and the difference was statistically significant (P <0.01) . A positive correlation was observed between the detection rate of CRKP and DDDS of carbapenems, and the difference was statistically significant (P<0.05) . The main infection of CRKP occurred in respiratory tract and urinary tract, and detection of CRKP was mainly from ICU, neurosurgery and geriatrics departments. Conclus ion CRKP infection increase year by year, which should receive sufficient clinical and infection control attention. Therapy of CRKP infection is mainly based on the combined tigecycline or polymyxin.-
Key words:
- Carbapenem-resistant Klebsiella pneumonia /
- Detection /
- Treatment strategy
-
[1]郭慧芳, 张燕军.耐碳青霉烯类抗生素肺炎克雷伯菌的耐药机制[J].山西医药杂志, 2017, 46 (21) :2588-2589. [2] [2]MACKENZIE F M, FORBES K J, DORAI-JOHN T, et al.Emergence of a carbapenem-resistant Klebsiella pneumonian[J].Lancet, 1997, 350 (9080) :783. [3]孙晔佳, 顾克菊.某院耐碳青霉烯类肺炎克雷伯菌检出与耐药表型分布[J].中国感染控制杂志, 2017, 16 (2) :130-137. [4]胡付品, 朱德妹, 汪复, 等.2015年CHINET细菌耐药性监测[J].中国感染与化疗杂志, 2016, 16 (6) :685-694. [5]马红映, 汪丽, 虞亦鸣, 等.院内获得耐碳青霉烯类抗菌药物肺炎克雷伯菌感染的危险因素分析[J].中华医院感染学杂志, 2017, 27 (7) :1456-1458. [6] 国家卫生计生委.国家卫生计生委办公厅关于进一步加强抗菌药物临床应用管理遏制细菌耐药的通知[EB/OL]. (2017-03-03) [2018-01-16]http://www.moh.gov.cn/yzygj/s7659/201703/d2f580480cef4ab1b97654 2b550f36cf.shtml. [7]张雯, 李传伟, 刘刚, 等.重症监护病房耐碳青霉烯肺炎克雷伯菌感染情况的临床分析[J].中华肺部疾病杂志 (电子版) , 2017, 10 (1) :5-9. [8]姚希, 徐丹慧, 贾建侠, 等.2011-2016年耐碳青霉烯肺炎克雷伯菌医院感染趋势分析[J].中华医院感染学杂志, 2017, 27 (12) :2652-2655. [9] 唐洪影, 胡志东.耐碳青霉烯药物肺炎克雷伯茵研究进展[J].国际流行病学传染病学杂志, 2017, 44 (4) :282-284. [10]王明贵译.广泛耐药革兰阴性菌感染的实验诊断、抗菌治疗及医院感染控制:中国专家共识[J].中国感染与化疗杂志, 2017, 17 (1) :82-92. [11]白艳, 柴栋, 李晨, 等.碳青霉烯类耐药肺炎克雷伯菌的联合用药的文献计量分析[J].中国临床药理学杂志, 2016, 32 (5) :462-465. [12]《抗菌药物临床应用指导原则》修订工作组.抗菌药物临床应用指导原则[M].2015版.北京:人民卫生出版社, 2015:29. [13]中华人民共和国卫生部医政司, 卫生部合理用药专家委员会.国家抗微生物治疗指南[M].北京:人民卫生出版社, 2012:64. [14] DAVID N, GILBERT, HENRY F.桑福德抗微生物治疗指南[M].第46版.北京:中国协和医科大学出版社, 2017:83. [15]吴风, 胡锡池, 胡仁静.感染碳青霉烯类耐药肺炎克雷伯菌患者全因死亡Meta分析[J].检验医学与临床, 2017, 14 (2) :217-221. -
点击查看大图
计量
- 文章访问数: 2075
- HTML全文浏览量: 723
- PDF下载量: 69
- 被引次数: 0
下载:
