院内感染肺炎克雷伯菌的影响因素及其耐药情况调查

doi:10.3969/j.issn.1671-7171.2024.07.003

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Abstract 【Objective】To explore the influencing factors and drug resistance of Klebsiella pneumoniae in hospital acquired infections. 【Methods】A total of 87 patients with hospital acquired infections admitted to our hospital from March 2018 to January 2023 were selected as the study subjects. Among them, 28 patients with hospital acquired infections of Klebsiella pneumoniae were included in the observation group, and 59 patients with hospital acquired infections of Acinetobacter baumannii were included in the control group. Two sets of general information were compared; Strain source, drug resistance, and virulence genes; The influencing factors and drug resistance of Klebsiella pneumoniae infection in the hospital were analyzed. 【Results】In the observation group, 21 cases (75.00%) were positive for mixed infections, including 5 cases (23.81%) of type A (Streptococcus pneumoniae), 4 cases (19.05%) of type B (Staphylococcus aureus), 2 cases (9.52%) of type C (Haemophilus influenzae), 4 cases (19.05%) of type A+B, 2 cases (9.52%) of type A+C, 3 cases (14.29%) of type B+C, and 1 case (4.76%) of type A+B+C. In the control group, 26 cases (44.07%) were positive for mixed infections, including 6 cases of type A (23.08%), 5 cases of type B (19.23%), 4 cases of type C (15.38%), 3 cases of type A+B (8.69%), 3 cases of type A+C (11.54%), 4 cases of type B+C (15.38%), and 1 case of type A+B+C (3.85%). There was no statistically significant difference (P>0.05) in age, gender, length of hospital stay, albumin levels, department distribution, white blood cell count (WBC) and indwelling catheter count, invasive procedures, and the proportion of infected patients staying in the same ward for ≥1 week or with incomplete final disinfection between the two groups; The observation group had a higher proportion of long-term use of broad-spectrum antibiotics, combined with at least 2 other bacterial infections, and early colonization of Klebsiella pneumoniae than the control group (P<0.05). The results of logistic regression analysis showed that long-term use of broad-spectrum antibiotics, concurrent infection with ≥2 other bacteria, and early colonization of Klebsiella pneumoniae were risk factors for hospital acquired Klebsiella pneumoniae infection in patients (P<0.05). 28 strains of bacteria mainly come from sputum and blood; Klebsiella pneumoniae has the highest resistance to piperacillin/tazobactam and ceftriaxone (100%), while it has the lowest resistance to tigecycline (3.57%) and tetracycline (7.14%); Among the 28 strains, 6 strains (21.43%) were high mucinous and 22 strains (78.57%) were non high mucinous. The positive rate of high mucinous strains in the wire drawing test was higher than that of non mucinous strains (P<0.05); The positive rates of virulence genes iroN, rmpA, and ybtS in high mucinous strains were higher than those in non mucinous strains (P<0.05). 【Conclusion】Long term use of broad-spectrum antibiotics, combined with at least 2 other bacterial infections, and early colonization of Klebsiella pneumoniae are risk factors for patients to be infected with Klebsiella pneumoniae. Klebsiella pneumoniae is more resistant to common antibiotics.

Key words： Klebsiella pneumoniae Cross Infection Drug Resistance, Multiple Root Cause Analysis

Received: 26 December 2023

PACS:

R563.11

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	YAN Ju
	ZHOU Xiumei
	ZHANG Xueqin

Cite this article:

YAN Ju,ZHOU Xiumei,ZHANG Xueqin. Investigation on the Influencing Factors and Drug Resistance of Klebsiella Pneumoniae Infection in Hospital[J]. JOURNAL OF CLINICAL RESEARCH, 2024, 41(7): 969-972.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2024.07.003 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2024/V41/I7/969

[1]	. [J]. JOURNAL OF CLINICAL RESEARCH, 2024, 41(8): 1222-1224.