肺炎克雷伯菌的临床特征及耐药性研究

Clinical characteristics and drug resistance of Klebsiella pneumonia

  • 摘要:
      目的  探讨肺炎克雷伯菌的临床特征及耐药性。
      方法  随机选取148例肺炎克雷伯菌感染患者作为研究对象,使用全自动细菌鉴定及药敏分析仪对肺炎克雷伯菌的临床特征与耐药性进行分析。
      结果  肺炎克雷伯菌主要来源于痰液,检出率显著高于其他来源(P < 0.05); 肺炎克雷伯菌对哌拉西林和氨苄西林的耐药率显著高于其他抗菌药物(P < 0.05); ICU肺炎克雷伯菌感染率最高,为29.29%, 显著高于神经内科的7.07%(P < 0.05); 产超广谱β-内酰胺酶(ESBLs)菌组与非产ESBLs菌组对氨苄西林、哌拉西林的耐药性基本一致,差异无统计学意义(P>0.05); 产ESBLs菌组对头孢他啶、氨曲南、头孢曲松、头孢唑啉、头孢吡肟、左氧氟沙星和庆大霉素的耐药率显著高于非产ESBLs菌组(P < 0.05)。
      结论  肺炎克雷伯菌感染普遍存在,以痰液为主要来源,耐药性明显,在诊疗工作中需采取合理有效的防范措施降低肺炎克雷伯菌感染风险。

     

    Abstract:
      Objective  To investigate the clinical characteristics and drug resistance of Klebsiella pneumoniae.
      Methods  A total of 148 patients with Klebsiella pneumoniae infection were selected as research subjects, and the clinical characteristics and drug resistance of Klebsiella pneumoniae were studied and compared with automatic bacterial identification and drug sensitivity analyzer.
      Results  Klebsiella pneumoniae mainly came from sputum, and its detection rate was significantly higher than other sources(P < 0.05). The resistance rates of Klebsiella pneumonia to piperacillin and ampicillin were significantly higher than that of other antibacterial drugs (P < 0.05). The infection rate of Klebsiella pneumoniae in ICU was the highest, which was significantly higher than that of neurological department (29.29% vs. 7.07%, P < 0. 05). The drug resistance of ESBLs producing bacteria and non-ESBLs producing bacteria to ampicillin and paracillin was basically the same, and there were no differences between the two groups (P>0.05). The resistance rate of ESBLs producing bacteria to ampicillin, paracillin, ceftazidime, ceftriaxone, cefepime, cefazo, gentamicin and levofloxacin was significantly higher than that of non-ESBLs producing bacteria(P < 0.05).
      Conclusion  Klebsiella pneumoniae infection commonly occurs and mainly originates from sputum with higher drug resistance, therefore, the reasonable and effective preventive measures should be taken to reduce its risk.

     

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