Wang Na, Zhan Minghua, Wang Teng, Liu Jinlu, Li Caiqing, Li Baoliang, Han Xuying, Li Huiying, Liu Shuting, Cao Jing, Zhong Xinran, Lei Chunmei, Zhang Wei, Zhang Zhihua
Microbiology Department, The First Affiliated Hospital of Hebei North University, Zhangjiakou, People's Republic of China.
Clinical Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, People's Republic of China.
Infect Drug Resist. 2023 Mar 4;16:1279-1295. doi: 10.2147/IDR.S401807. eCollection 2023.
Through long-term and large sample size statistical analysis, we revealed the pattern of (KP) infection and drug resistance and provided epidemiological data for the treatment and prevention and control of multidrug-resistant bacterial infection in our hospital.
Strains were identified using the BD Phoenix100 system, minimal inhibitory concentration of antibiotics were determined by the broth method, and data were statistically analyzed using WHONET 5.6 and SPSS27.0.
The isolation rate of KP from Enterobacteriaceae (26.2%, 4547/17358) in our hospital showed an increasing annual trend, ranking second only to . Carbapenem-resistant KP (CRKP) accounted for the highest proportion of carbapenem-resistant Enterobacteriaceae (72.2%, 431/597), showing an upward trend. Infected patients had a male-to-female ratio of approximately 2:1 and were mainly >60 years of age (66.2%), with intensive care units being the most commonly distributed department. Sputum was the most common specimen type (74.0%). Compared with spring and summer, autumn and winter were the main epidemic seasons for KP and extended-spectrum β-lactamase KP (ESBL-KP). The resistance rate of KP to common antibiotics was low, but all showed an increasing trend each year. ESBL-KP was >90% resistant to piperacillin, amoxicillin/clavulanic acid, and cefotaxime and less resistant to other common antibiotics, but showed an increasing trend in resistance to most antibiotics. CRKP resistance to common antibiotics was high, with resistance rates >90%, excluding amikacin (64.1%), gentamicin (87.4%), cotrimoxazole (44.3%), chloramphenicol (13.6%), and tetracycline (30.5%).
KP in our hospital mainly caused pulmonary infection in older men, which occurred frequently in autumn and winter, and the isolation and drug resistance rates showed an increasing trend. Age over 70 years, admission to intensive care unit, and urinary tract infection were found to be the risk factors for CRKP and ESBL-KP-resistance.
通过长期大样本量统计分析，揭示肺炎克雷伯菌（KP）感染及耐药模式，为我院多重耐药菌感染的治疗及防控提供流行病学资料。
采用BD Phoenix100系统鉴定菌株，肉汤法测定抗生素最低抑菌浓度，应用WHONET 5.6和SPSS27.0对数据进行统计分析。
我院肺炎克雷伯菌在肠杆菌科中的分离率（26.2%，4547/17358）呈逐年上升趋势，仅次于……。耐碳青霉烯类肺炎克雷伯菌（CRKP）在耐碳青霉烯类肠杆菌科细菌中占比最高（72.2%，431/597），呈上升趋势。感染患者男女比例约为2:1，主要为60岁以上人群（66.2%），重症监护病房为最常见分布科室。痰液是最常见的标本类型（74.0%）。与春夏季相比，秋冬季是肺炎克雷伯菌及产超广谱β-内酰胺酶肺炎克雷伯菌（ESBL-KP）的主要流行季节。肺炎克雷伯菌对常用抗生素的耐药率较低，但均呈逐年上升趋势。ESBL-KP对哌拉西林、阿莫西林/克拉维酸和头孢噻肟的耐药率>90%，对其他常用抗生素耐药率较低，但对大多数抗生素的耐药率呈上升趋势。CRKP对常用抗生素耐药率较高，耐药率>90%，但对阿米卡星（64.1%）、庆大霉素（87.4%）、复方磺胺甲恶唑（44.3%）、氯霉素（13.6%）和四环素（30.5%）除外。
我院肺炎克雷伯菌主要引起老年男性肺部感染，秋冬季节高发，分离率及耐药率呈上升趋势。70岁以上、入住重症监护病房及尿路感染是CRKP及ESBL-KP耐药的危险因素。
