[1]马　娟,王　翠,苍金荣,等.2016~2020年陕西省临床肺炎克雷伯菌分布及耐药性变迁[J].现代检验医学杂志,2021,36(06):132-135.[doi:10.3969/j.issn.1671-7414.2021.06.028]
　MA Juan,WANG Cui,CANG Jin-rong,et al.Distribution and Drug Resistance Tendency of Klebsiella Pneumoniae in Shaanxi Province from 2016 to 2020[J].Journal of Modern Laboratory Medicine,2021,36(06):132-135.[doi:10.3969/j.issn.1671-7414.2021.06.028]
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2016~2020年陕西省临床肺炎克雷伯菌分布及耐药性变迁()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年06期
页码:
132-135
栏目:
论　著
出版日期:
2021-12-15

文章信息/Info

Title:
Distribution and Drug Resistance Tendency of Klebsiella Pneumoniae in Shaanxi Province from 2016 to 2020
文章编号:
1671-7414（2021）06-132-05
作者:
马　娟; 王　翠; 苍金荣; 等
（陕西省人民医院a.检验科；b.陕西省临床检验中心，西安 710068）
Author(s):
MA Juan;  WANG Cui;  CANG Jin-rong;  et al
(a.Department of Clinical Medicine Laboratory,b.Shaanxi Provincial Center for Clinical Laborataries, Shaanxi Provincial People’s Hospital, Xi’an 710068, China)
关键词:
肺炎克雷伯菌; 多重耐药; 耐药监测
分类号:
R378.996；R446.5
DOI:
10.3969/j.issn.1671-7414.2021.06.028
文献标志码:
A
摘要:
目的　分析2016~2020年陕西省临床肺炎克雷伯菌的标本来源、科室分布及耐药性变迁，为临床抗感染治疗提供流行病学依据。方法　收集陕西省细菌耐药监测网156家成员单位2016~2020年分离的肺炎克雷伯菌及其药敏结果，采用2020年CLSI M100推荐的药敏折点作为判断标准[3]，使用WHONET5.6软件进行分析。结果　5年共分离肺炎克雷伯菌73 130株，前5位标本来源株数和占比分别为痰（48 860株，6.81%）、尿（6 968株，9.53%）、脓液及分泌物（5 970株，8.16%）、血及脑脊液（4 416株，6.04%）、其它无菌体液(912株,1.25%）。科室来源前5位株数和占比分别是重症医学科（7 115株，9.73%）、呼吸科（5 775株，7.90%）、神经外科（3 660株，5.00%）、儿科（2 973株，4.07%）及神经内科（2 250株，3.08%）。肺炎克雷伯菌对头孢唑林的耐药率最高（超过40%），头孢菌素、喹诺酮、硝基呋喃、磺胺和四环素等抗生素的耐药率较高，在16%~35%之间；头霉素、妥布霉素、氨曲南、部分含酶抑制剂药物如头孢哌酮/舒巴坦的耐药率较低，在10%~23%之间；碳青霉烯类、哌拉西林/他唑巴坦、阿米卡星等耐药率低于10%；除2016年出现少量菌株对替加环素耐药外，未出现替加环素耐药株，检出极少黏菌素耐药株。氨基糖苷类、磺胺类、部分酶抑制剂药物如头孢哌酮/舒巴坦等的耐药率有下降趋势，碳青霉烯类、其它含酶抑制剂药物如阿莫西林/克拉维酸及哌拉西林/他唑巴坦耐药率上升。耐碳青霉烯的肺炎克雷伯菌分离率地区分布不平衡，西安地区最高（2017年除外）。结论　陕西省肺炎克雷伯菌对碳青霉烯类及部分酶抑制剂复合制剂等高价值抗生素耐药率有上升趋势，提示仍需继续加强抗生素合理使用的管理，做好细菌耐药监测工作。
Abstract:
Objective　To study the distribution of specimen, department and drug resistance changes of Klebsiella pneumoniae in Shaanxi Province from 2016 to 2020. Methods　The isolates collected from 156 member units CARSS in Shaanxi from 2016 to 2020. The data were analyzed by WHONET 5.6 software according to the Clinical and Laboratory Standards Institute (CLSI) 2020 breakpoints. Results　A total of 73 130 Klebsiella pneumoniae were isolated, 66.81% isolates（48 860）were from lower respiratory tract, 9.53%（6 968）isolates from urine, 8.16% (5 970) isolates from fester and secretion, 6.04%(4 416)isolates from blood and cerebrospinal fluid, 1.25%(912) from other fluids. The top 5 department were from ICU(7 115, 9.73%).Respiratory Medicine (5 775，7.90%),Neurosurgery(3 660, 5.00%), Pediatric(2 973, 4.07%) and Neurology(2 250, 3.08%).Klebsiella pneumoniae isolates showed highest resistance to Cefazolin(>40%); Cephalosporin, Quinolone, Nitrofuran, Sulfa and Tetracycline maintained a high resistance rate between 16% and 35%. The resistance rates of Cephalomycin, Tobramycin, Amtronam and some enzyme-containing drugs, such as cefoperazone/sulbactam, were from 10% to 23%. Less than 10% isolates were resistant to Carbapenems, Piperacillin/Tazobactam and Amikacin. Little isolates were resistant to Colistin and Tetracycline. The carbapenem-resistant rate of Klebsiella pneumoniae was the highest in Xi’an（except 2017）.Conclusion　The resistance rates of Klebsiella pneumoniae to carbapenems and some enzyme inhibitor compound agents are increasing. It is necessary to strengthen the surveillance of bacterial resistance and the measures for control of infectious disease.

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更新日期/Last Update: 1900-01-01