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1、成人肺炎克雷伯茜败血症53例临床分析作者：李娟，王晓辉,吕哓菊单位：四川大学华西医院感染性疾病中心，成都610041【摘要】目的探讨肺炎克雷伯笛败血症临床特点和致病一幽药敏情况，为临床诊断和合理用药提供依据。方法阿顾性分析四川大学华酉医院2002年10月〜2007年10月5年中诊断为肺炎克雷伯菌败血症的所有病例，分析临床特点、基础疾病及微生物学特征。结果53例患者中,医院感染26例(49.1%),社区感染27例(50.9%)。社区感染患者常见基础疾病依次是糖尿病(59.3%),肝脓肿(55.6%),肺部感染(37%)。医院感染患者依次是恶性肿瘤(46.1%),肺部感染(26.
2、9%),重症胰腺炎(19.2%),医院感染者更易发生多器官功能衰竭。社区感染主要见于内分泌科与感染科,医院感染见于血液科与ICU。所有菌株对氨节与林均不敏感,对亚胺培南敏感性高(98.11%),菌株对第三、第四代头泡菌素敏感率社区感染菌96.3%、医院感染菊34.6%。结论肺炎克雷伯菌败血症主要见于内分泌科、血液科、感染科与ICU,医院感染肺炎克雷伯菌较社区感染菊株更加耐药，旦为耐药性强的多重耐药，应重视肺炎克雷伯幽败血症的防治，重视抗菌药物合理应用。【关键词】肺炎克雷伯菌一；败血症；耐药性Analysisofclinicalfeaturesof53caseswithKleb
3、siellapneumoniaesepticemiainadultsLiJuan,WangXiaohuiandLüXiaoju(CenterofInfectiousDiseases,WestChinaHospital,SichuanUniversity,Chengdu610041)ABSTRACTObjectiveToanalysetheclinicalcharacteristicsofKlebsiellapneumoniaesepticemiaandbacterialdrugresistancesoastoguideclinicaldiagnosisandrati
4、onaluseofantimicrobialagents.MethodsAretrospectivestudywascarriedoutin53adultpatientsofKlebsiellapneumoniaesepticemiafromOctober2002toOctober2007inWestChinaHospitalofSichuanUniversity.Theclinicalfeature,theunderlyingdiseasesandmicrobilogicalcharacteristicswereanalysed.ResultsIn53cases,26wer
5、ehospitalinfection(49.1%),theotherwerecommunityinfection(50.9%).Communityacquiredinfectionpatientswerecomplicatedbydiabetesmellitus(59.3%),liverabscess(55.6%)andpulmonaryinfection(37%).Hospitalinfectionpatientswerewithmalignanttumor(46.1%),pulmonaryinfection(26.9%),severepancreatitis(19.2%)
6、andmorevulnerabletoMODS.Communityinfectedpatientsmainlydistributedinendocrinologydepartmentandinfectiousdiseasesdepartment,hospitalinfectedpatientsmainlydistributedinhematologydepartmentandICU.AllKlebsiellapneumoniaeslntinswerenonsusceptibletoampicillin,highlysensitivetoimipenem(98.11%).The
7、sensitiverateofcommunityacquiredstrainstothethirdandthefourthgenerationcephalosporinswas96.3%,thatofhospitalacquiredstrainswas34.6%.ConclusionThehospitalacquiredstrainswasmoreresistantthancommunityacquiredstrains.Thesepticemiapatientsmainlydistributedine
