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目的:总结克雷白杆菌肺炎的临床特点。方法:分析27例克雷白杆菌肺炎临床资料,包括年龄、基础疾病、发病诱因、症 状与体征、X线检查、治疗与转归等,以及用K-B(纸片法)测定该菌的体外药物敏感性。结果:93％患者有基础病,其中COPD最 常见,混合菌感染7例,占26％,混合菌主要为绿脓杆菌和真菌;药物敏感测验提示共分离出58株肺炎克雷白杆菌,产超广谱β-内 酰胺酶(ESBLs)菌株15株,占25.9％,其对多种抗生素耐药,仅对亚胺培南和酶抑制剂复合物敏感。结论:克雷白杆菌肺炎患者中 63％为老年人,63％为医院感染,多有基础疾病,临床表现不典型,ESBLs菌株的产生,使多种抗菌药物耐药,治疗困难,诊断依靠病 原学并结合临床及X线检查,治疗应根据药敏并联合用药,避免滥用抗生素,防止耐药菌株的产生。
Objective: To summarize the clinical features of Klebsiella pneumoniae. Methods: The clinical data of 27 cases of Klebsiella pneumoniae were analyzed, including age, basic diseases, inducement, symptoms and signs, X-ray examination, treatment and prognosis, as well as in vitro drugs Sensitivity. Results: Ninety-three percent of the patients had underlying disease, of which COPD was the most common, mixed infection was 7 cases (26%) and mixed bacteria were mainly Pseudomonas aeruginosa and fungi. Drug susceptibility testing suggested that 58 strains of Klebsiella pneumoniae were produced Fifteen strains of extended-spectrum β-lactamases (ESBLs), accounting for 25.9%, were resistant to many antibiotics and sensitive to imipenem and enzyme inhibitor complex. Conclusions: 63% of Klebsiella pneumoniae patients are elderly and 63% are hospital-based. Most of them have underlying diseases and their clinical manifestations are not typical. The production of ESBLs strains makes many antimicrobials resistant and difficult to treat. Diagnosis depends on the pathogen Learn combined with clinical and X-ray examination, treatment should be based on drug sensitivity combined with medication to avoid abuse of antibiotics to prevent the emergence of drug-resistant strains.