社区获得性非产超广谱β-内酰胺酶肺炎克雷伯菌肺炎更易发生呼吸衰竭及脓毒性休克
Non-producing extended-spectrum β-lactamase Klebsiella pneumoniae community-acquired pneumonia is more likely to cause respiratory failure and septic shock

周卉芬.社区获得性非产超广谱β-内酰胺酶肺炎克雷伯菌肺炎更易发生呼吸衰竭及脓毒性休克[J].内科急危重症杂志,2021,27(5):401-404

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DOI：10.11768/nkjwzzzz20210511

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作者	单位	E-mail
周卉芬	南方医科大学附属小榄医院重症医学科	39240090@qq.com

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中文摘要:

目的：比较社区获得性产超广谱β-内酰胺酶肺炎克雷伯菌肺炎（ESBLs-KP-CAP）与非产ESBLs-KP-CAP临床特点的差异。方法：回顾性分析2017年1月至2019年10月入住南方医科大学附属小榄医院重症监护室138例KP-CAP患者的病历资料，比较产ESBLs-KP-CAP和非产ESBLs-KP-CAP患者的临床特点。结果：产ESBLs-KP-CAP与非产ESBLs-KP-CAP患者在人口学特征、APACHEⅡ评分、实验室及影像学检查、应用血管活性药、机械通气、气管切开、心力衰竭和急性肾衰竭、ICU住院≥7d及30d病死率等方面比较差异无显著性。产ESBLs-KP-CAP患者混合感染的比例更高（P＜0.05），以铜绿假单胞菌常见。非产ESBLs-KP-CAP患者发生呼吸衰竭及脓毒性休克的比例更高（P＜0.05）。结论：产ESBLs-KP-CAP患者混合感染更多见；非产ESBLs-KP-CAP患者呼吸衰竭和脓毒性休克的发生率更高，具有高毒力性。

英文摘要:

Objective: To compare the difference in clinical characteristics of producing extended-spectrum β-lactamase Klebsiella pneumoniae community-acquired pneumonia (ESBLs-KP-CAP) with non-producing ESBLs-KP-CAP. Methods: The clinical data of 138 patients diagnosed with KP-CAP who were admitted to Intensive Care Unit of Xiaolan Hospital of Southern Medical University from January 2017 to October 2019 were retrospectively analyzed. The differences in clinical characteristics between producing ESBLs-KP-CAP and non-producing ESBLs-KP-CAP patients were compared. Results: There were no significant differences in demographic information, APACHEⅡ score, laboratory and radiology examination results, usage of vasoactive agents, mechanical ventilation, tracheotomy, incidence of heart failure or renal failure, ICU hospitalization ≥7d and 30d mortality between two groups. The incidence of mixed infection in producing ESBLs-KP-CAP was significantly higher (P<0.05), and the most common bacteria were pseudomonas aeruginosa. The incidence of respiratory failure and septic shock was significantly higher in non-producing ESBLs-KP-CAP (P<0.05). Conclusion: Producing ESBLs-KP-CAP has more mixed infections, while non-producing ESBLs-KP-CAP has a higher incidence of respiratory failure and septic shock, and higher virulence.