Abstract:Objective To investigate the distribution and susceptibility of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolated from the First People′s Hospital of Shangqiu. Methods CRKP was collected from January 2014 to July 2017 and the results were analyzed, producing of carbapenemase and metallo-beta-lactamases were confirmed using Kirby-Bauer method. Results A total of 156 CRKP were collected and mainly from ICU (73.7%,115/156) and respiratory specimens (76.3%,119/156). The results of antimicrobial susceptibility testing showed that the sensitivity of polymyxin, tigecyline, minocycline and tetracycline were 100.0%, 92.8%, 88.5% and 64.1% respectively. The sensitive rates of methoxybenzidine-sulfamethoxazole, chloramphenicol amikacin, and levofloxacin were 39.7%, 30.1%, 29.5% and 23.1% respectively. It was serious resistant to beta-lactam, cephalosporin and its compound preparations. 78.2% CRKP produced carbapenemase (122/156) and 4 strains of metalloenzyme were isolated. Conclusion The patients from the ICU, neurology and geriatrics ward with respiratory tract infection should be importance of strengthen infection control in our hospital. To produce carbapenemase is the main method of local CRKP resistances. The situation of antibiotic resistance of CRKP is very serious except polymyxin and tetracycline species, so polymyxin, tigecyline and minocycline can be used in clinical practice of CRKP infection.
张爱荣. 156株耐碳青霉烯类肺炎克雷伯菌临床分布特点及其药物敏感性检测[J]. 中国医药导报, 2018, 15(11): 178-181.
ZHANG Airong. The characteristics of clinical distribution and surveillance of susceptibility for 156 strains of carbapenem-resistant Klebsiella pneumoniae. 中国医药导报, 2018, 15(11): 178-181.
[1] Esterly JS,Wagner J,McLaughlin MM,et al. Evaluation of clinical outcomes in patients with bloodstream infections due to Gramnegative bacteria according to carbapenem MIC stratification [J]. Antimicrob Agents Ch,2012,56(9):4885-4890.
[2] Trecarichi EM,Pagano L,Martino B,et al. Bloodstream infections caused by Klebsiella pneumoniae in onco-hematological patients:clinical impact of carbapenem resistance in a multicentre prospective survey [J]. Am J Hematol,2016,91(11):1076-1081.
[3] 杨丽君,陈坚,杨燕,等.碳青霉烯类耐药肺炎克雷伯菌基因型检测和同源性分析[J].中华检验医院杂志,2013, 36(4):318-323.
[4] 田磊,陈中举,孙自镛,等.2005-2014年CHINET肠杆菌属细菌耐药性监测[J].中国感染与化疗杂志,2016,16(3):275-283.
[5] 宋超,余加林,艾青,等.机械通气新生儿气管导管表面生物膜细菌多样性研究[J].中华儿科杂志,2013,51(8):602-606.
[6] Yvonne P,Angela C,Wolfgang W,et al. Resistance to cephalosporins and carbapenems in Gramnegative bacterial pathogens [J]. Int J Med Microbiol,300(6),371-379.
[7] Latania KL. Carbapenem resistant enterobacteriaceae:an emerging problem in children [J]. Clin Infect Dis,2012,55(6):852-859.
[8] 汪复,张婴元.实用抗感染治疗学[M].2版.北京:人民卫生出版社,2013.
[9] Daikos GL,Markogiannakis A Carbapenemase-producing Klebsiella pneumoniae:(when)might we still consider treating with carbapenems? [J]. Clin Microbiol Infec,2011, 17(8):1135-1141.
[10] 肖永红,胡云建.亚胺培南、美罗培南、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦对医院获得革兰阴性菌感染治疗方案的蒙特卡洛模拟评估[J].中华内科学杂志,2017, 56(8):595-600.
[11] 农金轻,赵晓丽,谷依林,等.1916株连续分离的肺炎克雷伯菌临床分布及耐药性变迁[J].中国医药科学,2018, 6(1):17-21.
[12] 唐景云,秦晓林.ESBLs在大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌中的检出率及耐药情况比较[J].中国医药科学,2016,6(3):175-178.
[13] 张筠,邓在春,马红映,等.不同碳青霉烯类药物治疗肺炎克雷伯菌肺炎临床效果观察[J].中国现代医生,2016, 54(2):73-75,78.
[14] 卢滔,方敏,彭春仙,等.产KPC酶肺炎克雷伯菌的感染分布特点及中西医药物结合对其的抑制效果[J].中国现代医生,2018,56(3):15-18.
[15] 邓锦有,梁小静,林桃.来源于患儿下呼吸道肺炎克雷伯菌的ESBLs检测及耐药性研究[J].中国医药科学,2016, 6(6):28-30,42.
[16] 郑雅卿,李鸿茹,黄珊珊,等.耐碳青霉烯类肺炎克雷伯菌的IMP-4耐药基因LAMP检测[J].中外医学研究,2017, 13(13):8-11.
[17] 卢得盛,褚美玲,乌含斯,等.急诊产超广谱β-内酰胺酶肺炎克雷伯菌感染的临床分析[J].中国临床实用医学,2017,8(1):69-71.
[18] 谭雪梅.肺炎克雷伯菌耐药表型的分布及其耐药性临床观察[J].中外医学研究,2018,14(2):76-77.
[19] Morrill HJ,Pogue JM,Kaye KS,et al. Treatment options for carbapenem-resistant Enterobacteriaceae infections [J]. Open Forum Infect Dise,2015,2(2):50-64.
[20] Olaitan AO,Diene SM,Kempf M,et al. Worldwide emergence of colistin resistance in Klebsiella pneumonia from healthy humans and patients in Lao PDR,Thailand,Israel,Nigeria and France owing to inactivation of the PhoP/PhoQ regulator mgrB:an epidemiological and molecular study [J]. Int J Antimicrob Agents,2014,44(6):500-507.