摘要
目的分析医院耐碳青霉烯肺炎克雷伯菌(CRKP)的流行趋势、分布特点及耐药性,为CRKP的防治提供临床依据。方法调查某院2012—2017年住院患者抗菌药物使用情况及CRKP分离率和耐药数据,采用χ^2检验、Spearman相关性检验等进行分析。结果6年共分离肺炎克雷伯菌1911株,其中280株为CRKP。CRKP检出率由2012年的0.4%上升至2017年的29.5%;重症监护病房(ICU)CRKP的分离率明显高于普通病房(P<0.05);CRKP检出与碳青霉烯类、第三代头孢菌素和青霉素酶抑制剂复方制剂的使用强度呈明显的正相关(P<0.05)。CRKP株对大多数抗菌药物的耐药率超过90%。结论该院CRKP分离率较高,与入住ICU及广谱β-内酰胺类、碳青霉烯类的用量有关,呈现多重耐药性。应加强抗菌药物管理,强化消毒、隔离等医院感染控制措施,以减少耐药株的播散和流行。
Objective To investigate the prevalence, distribution characteristics, and antibiotic resistance of carbapenem-resistant Klebsiella pneumoniae (CRKP) in a tertiary hospital from 2012 to 2017. Methods We extracted the data of Klebsiella pneumoniae isolates from inpatients from January 2012 to December 2017, carbapenem resistance was defined in accordance with the Clinical and Laboratory Standards Institute Guidelines. Antibiotic consumption data in the same period were expressed as the defined daily doses per 100 bed-days. SPSS 11.5 was used for statistic studies. Results Totally 280 CRKP isolates were found, showing an upward annual CRKP trends from 2012 to 2017 with the peak in 2016. The CRKP strains isolated from patients admitted to the intensive care unit were obviously higher than those from other wards. The consumption of third-generation cephalosprins, combinations of penicillins and carbapenem showed a significant correlation with the occurrence of CRKP (P<0.05). Over 90% CRKP strains were resistant to almost all anti-Gram negative bacterial antibiotics. Conclusion Incidence of CRKP was high in this hospital, which showed multidrug-resistance and might be correlated with the usage of broad-spectrum beta-lactam antibiotics and carbapenem and staying in the intensive care unit. The management strategy should be enhanced to reduce dissemination and prevalence of drug-resistant bacteria.
作者
王娜
阎彦
杨文明
张珍珍
魏颖
魏鹍
Wang Na;Yan Yan;Yang Wen-ming;Zhang Zhen-zhen;Wei Ying;Wei Kun(Department of Pharmacy, the First hospital of Qinhuangdao, Qinhuangdao 060000)
出处
《中国抗生素杂志》
CAS
CSCD
2019年第4期467-470,共4页
Chinese Journal of Antibiotics
基金
河北省卫生厅医学科学研究课题计划(No.20130288)
