解放军医学院学报2017，Vol.38Issue(11)：1029-1032,1054,5.DOI:10.3969/j.issn.2095-5227.2017.11.008
医院获得性肺炎克雷伯菌血流感染的临床特征及耐药菌株感染的危险因素分析
Carbapenem-susceptible versus carbapenem-resistant Klebsiella pneumoniae bloodstream infection: Clinical manifestations and risk factors
摘要
Abstract
Objective To study the clinical characteristics of K.pneumoniae bloodstream infection,and explore the risk factors for bloodstream infection caused by carbapenem-resistant K.pneumoniae (CRKP).Methods Clinical data about 190 cases with K.pneumoniae bloodstream infection in Chinese PLA General Hospital from June 2011 to August 2016 were retrospectively analyzed.The patients were divided into two groups according to resistance to carbapenem,patients with CRKP bloodstream infection and those with carbapenem-susceptive K.pneumoniae (CSKP) bloodstream infection.The independent risk factors of CRKP bloodstream infection were identified by logistic regression analysis.Results There were 190 non-duplicated K.pneumoniae blood isolates identified in our research,with the overall proportion of carbapenem-resistant strains reaching 31.6％ over the past five years.In logistic regression analysis,being exposed to antibiotics (OR=5.06,95％ CI:2.15-11.93,P=0.000),complicated with respiratory diseases (OR=3.99,95％ CI:1.49-10.7,P=-0.006) and receiving indwell invasive devices (OR=26.00,95％ CI:2.88-234.98,P=0.004) were identified as independent risk factors for CRKP bloodstream infection.Conclusion Carbapenem-resistant K.pneumoniae is an emerging multi-drug resistant nosocomial pathogen.Indwelling invasive devices in hospital and being exposed to antibiotics,especially carbapenem and beta-lactam/lactamase inhibitors,are associated with the produce of carbapenem-resistant strains.关键词
碳青霉烯类耐药/肺炎克雷伯菌/血流感染/危险因素Key words
carbapenem-resistant/Klebsiella pneumoniae/bloodstream infection/risk factor分类
医药卫生引用本文复制引用
杨修文,崔俊昌,赵进,倪文涛..医院获得性肺炎克雷伯菌血流感染的临床特征及耐药菌株感染的危险因素分析[J].解放军医学院学报,2017,38(11):1029-1032,1054,5.基金项目
国家自然科学基金项目(81371855)Supported by the National Natural Science Foundation of China(81371855) （81371855）
