Yayan Josef, Ghebremedhin Beniam, Rasche Kurt
From the HELIOS Clinic Wuppertal, Witten/Herdecke University, Wuppertal, Germany.
Medicine (Baltimore). 2015 Feb;94(6):e527. doi: 10.1097/MD.0000000000000527.
Klebsiella species are a common cause of community- and nosocomial-acquired pneumonia. Antibiotic resistance to the class of carbapenem in patients with pneumonia caused by Klebsiella species is unusual. New studies report carbapenem resistance in patients with pneumonia caused by Klebsiella species.This article examines, retrospectively, antibiotic resistance in patients with community- and nosocomial-acquired pneumonia caused by Klebsiella species.The data of all patients with community- and nosocomial-acquired pneumonia caused by Klebsiella species were collected from the hospital charts at the HELIOS Clinic, Witten/Herdecke University, Wuppertal, Germany, within the study period 2004 to 2014. An antibiogram was created from all of the study patients with pneumonia caused by Klebsiella species. Sensitivity and resistance profiles were performed for the different antibiotics that have been consistently used in the treatment of patients with pneumonia caused by Klebsiella species. All demographic, clinical, and laboratory data of all of the patients with pneumonia caused by Klebsiella species were collected from the patients' records.During the study period of January 1, 2004, to August 12, 2014, 149 patients were identified with community- and nosocomial-acquired pneumonia affected by Klebsiella species. These patients had a mean age of 70.6 ± 13 (107 [71.8%, 95% CI 64.6%-79%] men and 42 [28.2%, 95% CI 21%-35.4%] women). In all of the patients with pneumonia caused by Klebsiella species, there was resistance to ampicillin (P < 0.0001). Many patients with pneumonia caused by Klebsiella species (75.3%) also showed resistance to piperacillin (P < 0.0001). However, no patients with pneumonia caused by Klebsiella species showed resistance to imipenem or meropenem (P < 0.0001).Antibiotic resistance to the antibiotic class of carbapenem was not detected in patients with pneumonia caused by Klebsiella species.
克雷伯菌属是社区获得性肺炎和医院获得性肺炎的常见病因。由克雷伯菌属引起的肺炎患者对碳青霉烯类抗生素耐药并不常见。新研究报道了由克雷伯菌属引起的肺炎患者出现碳青霉烯类耐药情况。本文回顾性研究了由克雷伯菌属引起的社区获得性肺炎和医院获得性肺炎患者的抗生素耐药情况。在2004年至2014年的研究期间，从德国伍珀塔尔市维滕/黑尔德克大学HELIOS诊所的医院病历中收集了所有由克雷伯菌属引起的社区获得性肺炎和医院获得性肺炎患者的数据。为所有由克雷伯菌属引起的肺炎研究患者创建了一份抗菌谱。对一直用于治疗由克雷伯菌属引起的肺炎患者的不同抗生素进行了敏感性和耐药性分析。从患者记录中收集了所有由克雷伯菌属引起的肺炎患者的所有人口统计学、临床和实验室数据。在2004年1月1日至2014年8月12日的研究期间，确定了149例受克雷伯菌属影响的社区获得性肺炎和医院获得性肺炎患者。这些患者的平均年龄为70.6±13岁（男性107例[71.8%，95%可信区间64.6%-79%]，女性42例[28.2%，95%可信区间21%-35.4%]）。在所有由克雷伯菌属引起的肺炎患者中，对氨苄西林耐药（P<0.0001）。许多由克雷伯菌属引起的肺炎患者（75.3%）也对哌拉西林耐药（P<0.0001）。然而，没有由克雷伯菌属引起的肺炎患者对亚胺培南或美罗培南耐药（P<0.0001）。在由克雷伯菌属引起的肺炎患者中未检测到对碳青霉烯类抗生素的耐药情况。
