[1]赵　颖,李　茁,张　鹏,等.2014~2020年陕西省人民医院耐碳青霉烯类肺炎克雷伯菌检出率与同期抗生素暴露及相关危险因素分析[J].现代检验医学杂志,2021,36(06):192-196.[doi:10.3969/j.issn.1671-7414.2021.06.042]
　ZHAO Ying,LI Zhuo,ZHANG Peng,et al.Exploration of Risk Factors and the Antimicrobial Exposure Associated with Increased Detection of Carbapenem-resistant Klebsiella Pneumoniae in Shaanxi Provincial People’s Hospital from 2014 to 2020[J].Journal of Modern Laboratory Medicine,2021,36(06):192-196.[doi:10.3969/j.issn.1671-7414.2021.06.042]
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2014~2020年陕西省人民医院耐碳青霉烯类肺炎克雷伯菌检出率与同期抗生素暴露及相关危险因素分析()
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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:
192-196
栏目:
检验与临床
出版日期:
2021-12-15

文章信息/Info

Title:
Exploration of Risk Factors and the Antimicrobial Exposure Associated with Increased Detection of Carbapenem-resistant Klebsiella Pneumoniae in Shaanxi Provincial People’s Hospital from 2014 to 2020
文章编号:
1671-7414（2021）06-192-05
作者:
赵　颖; 李　茁; 张　鹏; 等
（陕西省人民医院，a.药学部；b.检验科；c.感染管理办公室，西安 710068）
Author(s):
ZHAO Ying;  LI Zhuo; ZHANG Peng;  et al
（a.Department of Pharmacy; b. Department of Clinical Laboratory；c. Infection Management office, Shaanxi Provincial People’s Hospital, Xi’an 710068, China）
关键词:
耐碳青霉烯类肺炎克雷伯菌; 感染危险因素; 抗生素消耗量; 合理用药
分类号:
R378.996；R446.5
DOI:
10.3969/j.issn.1671-7414.2021.06.042
文献标志码:
A
摘要:
目的　探究临床耐碳青霉烯类肺炎克雷伯菌（carbapenem-resistant klebsiella pneumoniae, CRKP）产生的相关危险因素，剖析引起耐药菌株增加的关键点，以期对抑制CRKP的产生提供重要信息。方法　选取2014~2020年陕西省人民医院CRKP检出率快速上升期患者病例资料，对比同期检出的碳青霉烯类敏感的肺炎克雷伯菌患者病例资料，分析产生CRKP的危险因素，并统计同期抗生素的消耗量以验证抗生素的使用与CRKP检出率的相关性。结果　2014~2020年CRKP检出率分别为9.47%，15.98%，14.5%，42.1%，48.5%，28.2%和20.6%。2016~2017年为快速上升期，抗生素的前期暴露（特别是碳青霉烯类抗生素和β-内酰胺酶抑制剂复合制剂的前期使用）、机械通气均为引起CRKP检出的危险因素（OR=4.0~11.9，均P<0.05）。碳青霉烯类抗生素和β-内酰胺酶抑制剂复合制剂的消耗量与CRKP的检出率具有显著相关性（r=0.273，0.452，均P=0.016），且在CRKP检出率快速上升期，β-内酰胺酶抑制剂复合制剂的消耗量与CRKP检出率呈高度正相关（r=0.784，P=0.021），在CRKP检出率下降期碳青霉烯类抗生素消耗量与CRKP检出率也呈正相关（r=0.215，P=0.035）。结论　碳青霉烯类抗生素及β-内酰胺酶抑制剂复合制剂的使用会使CRKP检出率上升。需要加强抗生素合理使用，降低CRKP检出率，遏制细菌耐药态势发展。
Abstract:
Objective　To explore the clinical related risk factors of carbapenem-resistant Klebsiella pneumoniae(CRKP) and analysed the key points that caused the increase of drug-resistant strains, in order to play a positive role in the control of the production of CRKP. Methods　Patients with carbapenem-resistant Klebsiella pneumoniae who were treated in Shaanxi Provincial people’s Hospital from 2014 to 2020 in the detection rate of drug-resistant bacteria increased sharply were chosen as the study group. Carbapenem-sensitive Klebsiella pneumoniae was detected in patients who served as control group during the same period. The data were retrospectively analyzed to explore the risk factors that might induce the generation of drug-resistant strains, and counted the consumption of antibacterial drugs in the same period to verify the correlation between the use of antibacterial drugs and the detection rate of CRKP. Results　The detection rates of CRKP from 2014 to 2020 were 9.47%, 15.98%, 14.5%, 42.1%, 48.5%, 28.2% and 20.6%, respectively. 2016~2017 was a period of sharp increase. Previous exposure to antimicrobials (especially the previous use of carbapenem antibacterial drugs and β-lactamase inhibitor combination preparations) and mechanical ventilation were risk factors for the detection of CRKP (OR=4.0~11.9, all P<0.05). The consumption of carbapenem and β-lactamase inhibitor combination preparations was correlated with the detection rate of CRKP (r=0.273, 0.452, all P=0.016). In addition, the consumption of β-lactamase inhibitor combination preparations was highly positively correlated with the detection rate of CRKP (r=0.784, P=0.021) during the rapid rise of CRKP detection. There was also a positive correlation between the consumption of carbapenems and the detection rate of CRKP during the decline phase of CRKP detection (r=0.215, P=0.035). Conclusion　The use of carbapenems and β-lactamase inhibitor combination preparations increased the detection rate of CRKP. It is necessary to strengthen the rational use of antibacterial drugs, reduce the detection rate of CRKP, and curb the development of bacterial resistance.

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备注/Memo

备注/Memo:
基金项目： 陕西省重点研发项目（2019SF-188）；陕西省人民医院科技人才支持计划项目（2021JY-30）；陕西省人民医院科技发展孵化基金资助项目(2016YX-11)。作者简介：赵颖（1990-），女，硕士，主管药师，主要从事抗感染等药物的合理使用，E-mail: zhaoyingsrm@163.com。通讯作者：李茁（1986-），男，博士，主管药师，E-mail:lizhuophd@163.com。
更新日期/Last Update: 1900-01-01