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目的探讨2011~2015年海军总医院肺炎克雷伯菌的临床分布情况及耐药性变迁,为临床用药提供参考依据。方法选取海军总医院2011~2015年临床分离出的肺炎克雷伯菌,分析其检出率、科室分布情况、标本来源、抗菌药物耐药性及对碳青霉烯类抗菌药物耐药性的变化趋势。结果 2011~2015年肺炎克雷伯菌的检出株数和分离率呈逐年上升趋势,标本主要来源于重症监护室、高压氧科、呼吸内科、放射肿瘤科、肾脏病科等10个科室,其中高压氧科检出率最高,其次是呼吸内科、重症监护室;送检标本以痰液和尿液为主,分别占送检标本的59.7%和21.4%;2011~2015年肺炎克雷伯菌耐药性呈逐年上升趋势。该菌对哌拉西林、氨苄西林、氨苄西林/舒巴坦和头孢呋辛酯耐药率较高,对阿米卡星、亚胺培南、美罗培南和妥布霉素的耐药率较低;对碳青霉烯类抗菌药物亚胺培南和美罗培南的耐药率逐年不断上升,泛耐药肺炎克雷伯菌呈快速上升趋势。结论肺炎克雷伯菌耐药现象严重,尤其耐碳青霉烯类抗菌药物的肺炎克雷伯菌近年来明显增加,应加强对其耐药性监测,指导临床合理用药。
Objective To investigate the clinical distribution and drug resistance changes of Klebsiella pneumonia in the Naval General Hospital from 2011 to 2015 and provide a reference for clinical use. Methods Klebsiella pneumoniae was isolated from the hospital of Naval General Hospital from 2011 to 2015. The detection rate, the distribution of departments, the source of samples, the antibiotic resistance and the resistance to carbapenem antibiotics were analyzed Trend. Results The number and separation rate of Klebsiella pneumoniae showed a trend of increasing year by year from 2011 to 2015. The specimens mainly came from 10 departments of intensive care unit, hyperbaric oxygenation, respiratory medicine, radiation oncology and nephrology, among which The highest detection rate of hyperbaric oxygen department, followed by respiratory medicine, intensive care unit; submission specimens to sputum and urine-based, accounting for the seized samples were 59.7% and 21.4%; 2011-2015 Klebsiella pneumoniae Drug resistance is increasing year by year. The bacteria resistant to piperacillin, ampicillin, ampicillin / sulbactam and cefuroxime axetil, amikacin, imipenem, meropenem and tobramycin resistance rate Low; carbapenem antibacterials imipenem and meropenem resistance rate increased year by year, pan-resistant Klebsiella pneumoniae showed a rapid upward trend. Conclusions Klebsiella pneumoniae is a serious drug-resistant strain. In particular, Klebsiella pneumoniae resistant to carbapenem-based antibiotics have been significantly increased in recent years. Drug resistance monitoring should be strengthened to guide clinical rational drug use.