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目的分析由肺炎克雷伯菌引起的血液感染患者的临床危险因素和耐药性,比较经典与高毒力肺炎克雷伯菌感染的区别。方法回顾性分析本院2012年-2015年127例感染肺炎克雷伯菌的菌血症患者的临床特征。结果 127株肺炎克雷伯菌中筛选出高毒力型22株。38.3%感染经典肺炎克雷伯菌者是肿瘤患者,医院获得性占67.3%。而毒力型肺炎克雷伯菌的血液感染以社区获得性为主,占81.8%。肝脏疾病、社区获得性、糖尿病是感染毒力型肺炎克雷伯菌的危险因素。药敏结果显示高毒力肺炎克雷伯菌对氨苄西林-舒巴坦、庆大霉素、左氧氟沙星和复方新诺明敏感率比经典肺炎克雷伯菌高。结论血液感染的肺炎克雷伯菌耐药率高,需引起临床的高度重视,特别对于高毒力型肺炎克雷伯菌的易感人群,必须采取有效措施控制其传播。
Objective To analyze the clinical risk factors and drug resistance in patients with blood-borne infection caused by Klebsiella pneumoniae and to compare the difference between classic and highly virulent Klebsiella pneumoniae infection. Methods The clinical features of 127 patients with bacteremia of Klebsiella pneumoniae from 2012 to 2015 in our hospital were retrospectively analyzed. Results Among 127 strains of Klebsiella pneumoniae, 22 strains were screened for high virulence. 38.3% of those infected with classical Klebsiella pneumoniae were cancer patients, with hospital acquired 67.3%. The virulent Klebsiella pneumoniae infection was community-based, accounting for 81.8%. Liver disease, community acquired, and diabetes mellitus are risk factors for virulent K. pneumoniae infection. Susceptibility results showed that virulence of Klebsiella pneumoniae to ampicillin - sulbactam, gentamicin, levofloxacin and cotrimoxazole susceptibility than classical Klebsiella pneumoniae. Conclusion The blood-infected Klebsiella pneumoniae has a high drug resistance rate, which needs clinical attention. Especially for susceptible population of highly virulent Klebsiella pneumoniae, effective measures must be taken to control the spread of Klebsiella pneumoniae.