小儿肺炎克雷伯杆菌肺炎临床特点与治疗策略

目的探讨婴幼儿肺炎克雷伯杆菌肺炎临床特点及治疗策略。方法分析132例婴幼儿肺炎克雷伯杆菌肺炎临床特点、药敏结果及治疗情况。结果婴幼儿肺炎克雷伯杆菌肺炎临床主要症状为咳嗽,咳白色粘痰,喘息,呼吸困难;胸片双侧实质病变多见,易并发肺不张,重症肺炎发生率42.4%。产ESBLs菌株占53.0%,药敏显示对青霉素类、头孢菌素类耐药率83%~100%;碳青霉烯类耐药率6%~30%,较无ESBLs菌株有显著差异。结论婴幼儿肺炎克雷伯杆菌肺炎多见于有基础疾病患儿,耐药率高,重症肺炎发生率高。符合重症肺炎标准治疗建议首选碳青霉烯类药物抗感染。

The clinical characteristics and therapy strategies of Klebsiella pneumonia of infants

Objective To investigate the clinical characteristics and therapy strategies of Klebsiella pneumonia of infants.Methods Analyze the clinical characteristics,results of drug sensitivity and treating process of the 132 cases of Klebsiella pneumonia of infants.Results The main symptoms of it were cough,expectorating white phlegm,wheezing and dyspnoea.Bilateral lesions appeared frequently in the sternum.It was easily complicated by atelectasis.The incidence of severe pneumonia was 42.4%.Extended spectrum β lactamases strains were accounted for 53.0%.The results of drug sensibility indicated that they possess 83%～100% of drug resistance rate towards penicillins and Cephalosporins;and 6%～30% towards carbapenems.They had significant difference from those without ESBLs strains.Conclusion It＇s more common in infants with underlying diseases.The drug resistance rate and incidence of severe pneumonia were higher.Carbapenems were the first choice of treatment if they complied with the standards of severe pneumonia.