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- Title
ICU肾功能不全患者耐碳青酶烯类肺炎克雷伯菌的分布特征及耐药特性分析.
- Authors
喻声洋; 胡玉清; 方卫华; 黄佳鹏; 高威; 王新平
- Abstract
Objective: To investigate and analyze the distribution and drug resistance of carbapenem-resistant Klebsiella pneumoniae in patients with renal insufficiency in intensive care unit(ICU). Methods: From February 2015 to December 2017, 46 specimens of patients with renal insufficiency in ICU were collected. The source of specimen and the clinical data of patients were investigated, the pathogens were isolated and identified. Results: A total of 165 strains of Carbapenem resistant Klebsiella pneumoniae were isolated from 46 cases of patients. The specimens were derived from 6 cases of urine, 20 cases of sputum, 4 cases of blood, 10 cases of lavage fluid, 3 cases of secretion, 3 cases of bile. The resistance rates of 165 strains of carbapenem-resistant Klebsiella pneumoniae to meropenem, imipenem and ertapenem, retinoic acid and ciprofloxacin, cefalotin, cefotaxime, ampicillin, amoxicillin/carat were over80%, and the resistance rates to piperacillin/tazobactam and gentamicin were about 75%, and for the tetracycline and tega were below40%. Among the 46 patients, there were 16 cases were cured, 17 cases were improved, 13 cases were ineffective, and the total effective rates were 71.74%; the average hospital stay in ICU were(11.48±2.11)d; the total hospital stay were(45.29±1.48)d, and the hospital died were 11 case that the rates 23.91%. Multivariate logistic regression analysis showed deep venous catheterization(OR=1.893), age≥65 years(OR=2.154), use of carbapenem antibiotics(OR=2.041) for ICU patients with renal insufficiency Patients had independent risk factors for carcinol-resistant Klebsiella pneumoniae infection(P <0.05). Conclusion: The patients with renal insufficiency in ICU are resistant to carcinol-resistant Klebsiella pneumoniae, which are mostly derived from sputum specimens and have low resistance to minocycline, tetracycline and tigecycline. These drugs can be selected clinically. Reasonably grasp the time and dosage of medication,and enhance the efficiency of anti-infection. At the same time, deep venous catheter placement, age ≥65 years, the use of carbapenem antibiotics as the main risk factors in the treatment process, in the treatment of ICU patients with renal insufficiency, should be considered, improve treatment efficiency.
- Publication
Progress in Modern Biomedicine, 2019, Vol 19, Issue 10, p1924
- ISSN
1673-6273
- Publication type
Article
- DOI
10.13241/j.cnki.pmb.2019.10.025