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目的了解碳青酶烯类耐药肺炎克雷伯菌和大肠埃希菌的分布及耐药性,为临床经验治疗提供依据。方法回顾性分析2012-2016年门急诊及住院患者分离的肺炎克雷伯菌与大肠埃希菌的病原学资料及其临床资料。结果共分离肺炎克雷伯菌3 782株和大肠埃希菌6 567株,其中碳青霉烯类耐药肺炎克雷伯菌和大肠埃希菌分别为219株,44株,检出率分别为5.79%、0.67%。碳青霉烯类耐药肺炎克雷伯菌标本主要来自痰液,占78.54%(172/219);碳青霉烯类耐药大肠埃希菌标本主要来自尿液和痰液,分别占47.73%(21/44)、34.09%(15/44)。碳青霉烯类耐药肺炎克雷伯菌主要分离自重症医学科(ICU)、神经外科重症监护室(NICU)及肺移植科,分别占37.44%(82/219)、15.98%(35/219)和10.50%(23/219);碳青霉烯类耐药大肠埃希菌主要分离自老年病科、门急诊及ICU,分别占15.91%(7/44)、13.64%(6/44)及11.36%(5/44)。碳青霉烯类耐药肺炎克雷伯菌仅对阿米卡星及妥布霉素耐药率较低(35.16%、45.66%),碳青霉烯类耐药类大肠埃希菌对呋喃妥因、阿米卡星及妥布霉素耐药率较低(25.00%、34.09%及43.18%)。结论碳青酶烯类耐药肺炎克雷伯菌检出率高于大肠埃希菌,两者年龄分布相似,但标本来源、科室分布及耐药性均存在一定差异。
Objective To understand the distribution and drug resistance of kallikrein-resistant Klebsiella pneumoniae and Escherichia coli, and to provide basis for clinical experience. Methods The etiologic data and clinical data of Klebsiella pneumoniae and Escherichia coli isolated in outpatients and inpatients from 2012 to 2016 were retrospectively analyzed. Results A total of 3 782 strains of Klebsiella pneumoniae and 6 567 strains of Escherichia coli were isolated. Among them, 219 strains and 44 strains of Klebsiella pneumoniae and Escherichia coli were resistant to carbapenem, respectively. The detection rates were 5.79%, 0.67%. Carbapenems-resistant Klebsiella pneumoniae specimens mainly from sputum, accounting for 78.54% (172/219); carbapenem-resistant Escherichia coli specimens mainly from urine and sputum, accounting for 47.73 % (21/44), 34.09% (15/44). The carbapenems-resistant Klebsiella pneumoniae were mainly isolated from the ICU, NICU and lung transplantation departments, accounting for 37.44% (82/219), 15.98% (35 / 219) and 10.50% (23/219) respectively. The carbapenem-resistant Escherichia coli was mainly isolated from geriatrics, outpatient and emergency department and ICU, accounting for 15.91% (7/44) and 13.64% (6/44) ) And 11.36% (5/44) respectively. The resistance rates of carbapenem-resistant Klebsiella pneumoniae to amikacin and tobramycin were only low (35.16%, 45.66%), carbapenem-resistant Escherichia coli , Amikacin and tobramycin were lower (25.00%, 34.09% and 43.18%). Conclusions The detection rate of Klebsiella pneumoniae resistant to carbapenem - resistant pneumonia is higher than that of Escherichia coli. The age distribution of the two strains is similar, but there are some differences in the origin of samples, the distribution of departments and the drug resistance.