Analysis Of Drug Resistance Of Klebsiella Pneumoniae And Risk Factors Of Carbapenem-resistant Strains Infection In Different Parts Of ICU

Objective:To study the drug resistance of Klebsiella pneumoniae in different parts of ICU and the risk factors for infection of resistant strains of resistant to carbon.Methods:The epidemiological data of 173 Klebsiella pneumoniae strains isolated from different parts of ICU ward of our hospital from January 2012 to December 2013 were analyzed retrospectively, the strains from different parts were divided respectively according to the carbapenem antibiotics into carbapenem resistant group and sensitive group; the drug resistance and prognosis of the two groups were compared; and the risk factors of infection of carbapenem-resistant Klebsiella Pneumoniae were analyzed by using the sensitive group as the control group.Results:173 strains of Klebsiella pneumoniae, from infected blood has 48 strains and pulmonary infection with 91 strains and urinary tract infection with 12 strains and abdominal infection with 18 strains, wound infection with 4 strains.173 strains of Klebsiella pneumoniae were studied, among which 78 and 45.09% were resistant to carbon.29 strains from 48 strains of blood infection Klebsiella pneumonia were resistant to carbon, the drug resistance rate was 60.42%,91 strains isolated from lower respiratory tract of Klebsiella pneumoniae has 34 strains of carbapenem-resistant Klebsiella pneumoniae, the resistant rate of 37.62%; 12 strains of urine separation of Klebsiella pneumoniae with 6 strains of carbapenem-resistant, the resistance rate of 50%.18 strains of peritoneal drainage fluid separation of pneumonia 7 of carbapenem resistant Klebsiella pneumoniae, the resistant rate was 38.89%.4 strains of secretions in the separation of Klebsiella pneumoniae resistant to carbapenem antibiotics with 2 strains, the drug resistance rate of 50%. Because of urinary tract infection, abdominal infection and wound infection in patients with small sample size, it is only in this study, the blood infection and lung infection group for the next step of drug resistance, prognosis and risk factors analysis. In the analysis of drug resistance in blood and sputum isolates of Klebsiella pneumoniae were almost the same, except ampicillin and CO trimoxazole, resistance to carbapenem class group of bacteria to test antibiotics resistance was significantly higher than that of the sensitive group. But there was no significant difference in mortality rate, bacterial clearance rate,7 innate survival rate, and 28 innate survival rate between the resistant and susceptible groups, there was no statistical significance between the two.The univariate and multivariate logistic regression analysis showed that in the analysis of the risk factors associated with carbapenem-resistant Klebsiella pneumoniae bloodstream infection risk factors for insertion of deep vein catheter (OR=22.823) and exposure to antibiotics of carbon (OR=7.943), and the independent risk factors of pulmonary infection for carbapenem-resistant Klebsiella pneumoniae is older than 65 years (OR=3.749), use of cephalosporins antibiotics (OR=4.276) and use of carbapenem antibiotics (OR=8.435).Conclusion:The carbapenem-resistant rate of Klebsiella pneumoniae in ICU was high. Insertion of deep vein catheter (OR=22.823) and exposure to antibiotics of carbon are independent risk factors for the infection of carbapenem-resistant Klebsiella pneumoniae.65 years of age or older, use of cephalosporins and carbapenems antibiotics is an independent risk factor for pulmonary infection of carbapenem-resistant Klebsiella pneumonia.