Clinical Distribution And Drug Resistance Analysis Of Klebsiella Pneumoniae

Research purposeKlebsiella pneumoniae(KP)second only to the gram-negative bacterium escherichia coli become the second major pathogenic bacteria,and the detection rate and resistant rate increased year by year,to understand our hospital clinical distribution and drug resistance of bacteria Klebsiella pneumonia,collected from our hospital clinical laboratory from January 2017 to December,clinical separation of pneumonia Klebsiella strains,analyze its source of specimen,the clinical distribution and drug resistance situation and so on,provides some references for the rational use of antibiotics for clinicians.MethodsA retrospective analysis of research methods,by donghua software system collected from January 2017 to December makes clinical specimens of all kinds of klebsiella pneumoniae isolated from the related data,summarize specimen source of klebsiella pneumoniae,population distribution,distribution department,basic disease,the usage of antibiotics,laboratory tests and drug susceptibility results,etc.Excel was used to establish the database and SPSS23 statistical software was used for analysis.The measurement data were expressed as mean±standard deviation(x±s),and the counting data were expressed as rate or composition ratio.Chi-square test orFisher exact probability method was used to compare the data between the groups,and P<0.05 indicated statistically significant difference.Results1.A total of 583 klebsiella pneumoniae strains were collected from 516 patients in our hospital from January to December 2017,including 359 males(70%)and 157 females(30%),with an average age of 58.39±17.08 years.2.The top three specimens were 217 strains of sputum,118 strains of secretions and 76 strains of urine,accounting for 37.22%,20.24%and 13.04%of the total bacterial strains,respectively.The drug resistance of KP isolated from sputum,secretions and urine samples to antibacterial agents other than compound sulfonamide,tigacycline and tetracycline was significantly different and statistically significant(P<0.05).3.The top three strains of klebber pneumoniae in the clinical departments were 307 strains in Intensive Care Unit(ICU),71 strains in the department of hepatobiliary and pancreatic surgery,and 53 strains in the department of respiratory medicine,accounting for 52.83%,12.18%,and 9.09%of the total strains,respectively.In addition to ampicillin,cefuroxime,chloramphenicol,tegacycline and tetracycline,there were significant differences in antimicrobial resistance of KP strains isolated from ICU,hepatobiliary and pancreatic surgery,and respiratory medicine(P<0.05).4.The drug resistance rates of the top three were ampicillin 98.49%,ceftriaxone 84.62%and cefazolin 83.33%,respectively.KP's sensitivity to antibiotics ranked the top three in terms of polymyxin 100.00%,ertapenem 100.00%and amikacin 99.38%.The drug resistance rate of KP to cephalosporins and quinolones in our hospital was more than 50%.5.A total of 229 strains of extended spectrum amase(ESBL)were detected in 583 strains of KP,among which 146 were ESBL positive,with a detection rate of 63.76%.A total of 193 strains of carbapenem-resistant Klebsiella Pneumoniae(CRKP)were detected from 583 strains of KP,with a detection rate of 33.10%.The esbl-positive strains developed resistance to antibiotics such as penicillin,cephalosporin,monocyclic,etc.,and there was a difference in drug resistance between ESBL positive and negative cases,with statistical significance(P<0.05).CRKP developed significant resistance to most commonly used antimicrobial agents.ConclusionA total of 583 strains of KP were collected and isolated from 516 patients,including 359 males(70%)and 157 females(30%),with an average age of 58.39 ±17.08 years.The most common source of specimens is sputum.KP of sputum specimens is generally resistant to other antibacterial drugs except tegacycline,tetracycline and chloramphenicol.Secondly,secretions,mostly from surgery,have lower drug resistance than KP in sputum samples.Urine specimen source is ranked third,isolated from the urine of KP in common urinary tract quinolone antibacterial drugs resistant rate is more than 50%,for add ring element of carbon alkene antimicrobial agents has high sensitivity,so our KP of urinary tract infection caused by quinolones is invalid when the preferred penicillium carbon alkene antimicrobial agents.The most common department distribution is ICU,where the detection rate of CRKP is high,and KP in ICU has a high resistance to antibacterial drugs except tegacycline and tetracycline.Followed by courage pancreas surgery,the department of KP bacterial liver abscess,and patients with diabetes,liver and gallbladder surgery isolated pancreas of KP to ampicillin,generation cephalosporin class,the second generation cephalosporin class of commonly used antimicrobial resistance is low,so the departments treat infections caused by bacteria pneumonia klebsiella can be preferred three generation cephalosporin class of antimicrobial drugs such as he totally cephalosporin class of antimicrobial agents,enzyme inhibitors,etc.;The third department was the department of respiratory medicine.KP isolated from this department was all derived from sputum samples,and antimicrobial resistance was basically consistent with sputum samples.The detection rate of ESBL and CRKP in our hospital was 63.76%and 33.10%respectively.This study KP on carbon penicillium alkene antibiotic resistance in ESBL positive cases were at about 50%,in the case of ESBL negative resistance is lower,and the resistance difference statistically significant(P<0.05),therefore,the clinical treatment of ESBL positive caused by klebsiella pneumoniae infection can be preferred penicillium carbon alkene antimicrobial agents.In our hospital,CRKP showed significant resistance to commonly used antimicrobial drugs,but low resistance to tigacycline.If necessary,tigacycline or combination drug can be used.