王良方;李刚;侯晓慧;尹晓丽;王文;李莎莎;陶佳;赵梅;胡瑞;贾伟;师志云;

• 1:宁夏医科大学总医院医学实验中心
• 2:宁夏医科大学临床医学院
• 3:宁夏医科大学总医院宁夏临床病原微生物重点实验室

摘要(Abstract)：

目的 了解某医院7年间肺炎克雷伯菌(KP)及耐碳青霉烯类肺炎克雷伯菌(CRKP)的临床分布和抗菌药物耐药性的变化和趋势，为临床医生和决策部门对抗菌药物的合理使用提供支持。方法 收集2015-2021年某医院临床分离的KP及CRKP菌株，采用WHONET 5.6和SPSS 26.0软件对标本来源、科室来源、药敏试验结果及常用抗菌药物的耐药性变迁进行回顾性分析。结果 2015-2021年共分离非重复KP 8 181株，急诊科检出率最高(15.69%);主要分离自痰液(51.83%)。KP对头孢唑林、亚胺培南和阿米卡星的平均耐药率分别为64.36%、3.97%和3.31%。2015-2018年肺炎克雷伯菌对常见抗菌药物的耐药性有明显上升，从2018年开始，近两年肺炎克雷伯菌对常见抗菌药物及亚胺培南、美罗培南等碳青霉烯类抗菌药物的耐药性出现下降。2015-2021年共分离CRKP 327株，检出率呈上升趋势，近两年检出率有所下降。CRKP对头孢菌素类等临床常用抗菌药物均表现为高度耐药，对庆大霉素、左氧氟沙星等抗菌药物耐药性出现下降，对多黏菌素B、替加环素敏感。结论 2015-2021年间该医院临床分离KP和CRKP菌株对多数抗菌药物的耐药率总体呈先上升后下降的趋势。耐药率总体趋势呈上升趋势，定期进行细菌耐药性监测有助于了解细菌耐药性变化，预防和控制CRKP的产生和传播。

关键词(KeyWords)： 耐碳青霉烯类肺炎克雷伯菌;临床分布;耐药变迁;耐药性

Abstract:

Keywords:

基金项目(Foundation): 国家科技基础资源调查专项(2019FY101200);; 宁夏自然科学基金项目(2021AAC03326);; 宁夏医科大学校级创新训练项目(X202210752036)

作者(Authors): 王良方;李刚;侯晓慧;尹晓丽;王文;李莎莎;陶佳;赵梅;胡瑞;贾伟;师志云;

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