| 替加环素耐药肺炎克雷伯菌的分布及耐药性分析 |
| |
| 引用本文： | 阮永春,周宜庆,张海旺,于丽侠,王丹,曾敏,周洁,李明晖.替加环素耐药肺炎克雷伯菌的分布及耐药性分析[J].中华全科医学,2020,18(8):1404-1408. |
| |
| 作者姓名： | 阮永春 周宜庆 张海旺 于丽侠 王丹 曾敏 周洁 李明晖 |
| |
| 作者单位： | 绍兴市人民医院(浙江大学绍兴医院)感染性疾病科, 浙江 绍兴 312000 |
| |
| 基金项目： | 浙江省医药卫生科研基金项目(2017KY151,2018KY830)浙江省绍兴市公益性技术应用研究计划项目(2017B70030,2018C30101) |
| |
| 摘 要： | 目的 调查替加环素耐药肺炎克雷伯菌(TRKP)的临床分布和耐药特性,为临床的防治提供依据。 方法 收集2015年1月—2018年12月绍兴市人民医院住院患者各类送检标本中分离的261株TRKP,采用VITEK-2 compac型全自动微生物分析仪进行细菌鉴定及药敏试验;用K-B法加测其他临床常用抗菌药物的敏感性;并对TRKP的临床分布特点及其对抗菌药物的耐药情况进行调查分析。 结果 261株TRKP主要来自痰液(123例,47.13%)、尿液(55例,21.07%)和胆汁(37例,14.18%)。TRKP的科室分布主要是ICU(含EICU)、肝胆外科和神经外科(含NICU),分别占22.61%、17.62%和15.71%。在22种抗菌药物中,TRKP对5种抗菌药物耐药率超过80%,对14种抗菌药物耐药率超过50%,而合并碳青霉烯类抗菌药物耐药的TRKP菌株,对16种抗菌药物耐药率超过90%,对20种抗菌药物耐药率超过80%。TRKP为多重耐药(MDR)菌株总共有249株,占95.40%,其中合并碳青霉烯类抗菌药物耐药的TRKP菌株有93株,其多重耐药(MDR)率达到100%。TRKP对丁胺卡那的总体耐药率相对较低,为16.09%,对各种抗菌药物的耐药率在肝胆外科均不高于ICU和神经外科。 结论 TRKP临床分布广泛,耐药情况严重,临床可供选择的抗菌药物有限,丁胺卡那为少数可选药物之一。
|
| 关 键 词： | 克雷伯菌 肺炎 替加环素 耐药 调查分析 |
| 收稿时间： | 2019-01-27 |
Distribution and drug resistance analysis of tigecycline-resistant Klebsiella pneumoniae |
| |
| Affiliation: | Department of Infectious Diseases,Shaoxing People's Hospital(Shaoxing Hospital,Zhejiang University School of Medicine),Shaoxing,Zhejiang 312000,China |
| |
| Abstract: | Objective To investigate the clinical distribution and drug resistance of tigecycline-resistant Klebsiella pneumoniae(TRKP), and to provide evidence for clinical prevention and treatment. Methods Total 261 strains of TRKP isolated from various samples of inpatients from Shaoxing People's Hospital from January 2015 to December 2018 were collected. VITEK-2 compac automatic microbial analyzer was used for bacterial identification and drug susceptibility test. The sensitivity of other clinical commonly used antimicrobial agents was measured by K-B method. Clinical distribution characteristics of TRKP and its resistance to antimicrobial agents were studied and analyzed. Results The 261 strains of TRKP were isolated mainly from sputum(n=123, 47.13%), urine(n=55, 21.07%) and bile(n=37, 14.18%), and the stains were mainly originated from ICU(including Emergency ICU), department of hepatobiliary surgery and department of neurosurgery(including Neurosurgery ICU), accounting for 22.61%, 17.62% and 15.71%, respectively. Among the 22 antimicrobial agents, TRKP was more than 80% resistant to 5 and 50% resistant to 14. The resistant rate of TRKP strains which were also resistant to carbapenem was over 90% to 16 species antimicrobial agents and over 80% to 20 species. A total of 249 strains of TRKP, accounting for 95.40%, were multidrug-resistant strains. Furthermore, 93 TRKP strains which were also resistant to carbapenem, accounting for 100%, were multidrug-resistant strains. The overall resistance rate of TRKP to amikacin was relatively low at 16.09%, and the resistance rate to various antibiotics in the department of hepatobiliary surgery was not higher than that in the ICU and the department of neurosurgery. Conclusion There is a wide range of clinical distribution of TRKP, of which the drug resistance is serious. Antimicrobial agents can be available is limited for treatment of TRKP, and amikacin is one of the few optional drugs. |
| |
| Keywords: | |
|
| 点击此处可从《中华全科医学》浏览原始摘要信息 |
|
点击此处可从《中华全科医学》下载全文 |
|
