【摘要】 目的 分析耐碳青霉烯类肺炎克雷伯菌（CRKP）不同感染类型历年的检出情况及分布特点，为制定符合本地区的CRKP的综合防控措施提供参考依据。方法 回顾性收集2017年1月—2023年12月入住福建医科大学附属第二医院确诊为肺炎克雷伯菌（KPN）感染患者的病例资料，经药敏试验判断为碳青霉烯类耐药的肺炎克雷伯菌（CRKP）感染患者和碳青霉烯类敏感的肺炎克雷伯菌（CSKP）感染，分析CRKP检出和感染变化趋势。结果 2017—2023年共有肺炎克雷伯菌感染患者3 444例，其中230例检出CRKP，总检出率为6.68%，医院感染的CRKP检出率为7.46%(73/979)，社区感染的CRKP检出率为6.37%(157/2465)。医院感染CRKP（χ~2=52.019,P<0.000 1）和社区感染CRKP（χ~2=143.113,P<0.000 1）各年份的检出率呈上升趋势，差异有统计学意义；男性CRKP的检出率（7.46%）高于女性（5.10%），差异有统计学意义（χ~2=6.822,P=0.009）;CRKP在中年（45～60岁）患者中的检出率最高（6.12%）。医院感染和社区感染CRKP在不同感染部位的分布不同，医院感染CRKP在各感染部位分布无明显差异（χ~2=34.441,P=0.077），社区感染CRKP在各感染部位分布差异有统计学意义（χ~2=88.132,P<0.000 1），以下呼吸道感染最常见，检出率9.52%。结论 医院及社区CRKP检出率逐年上升，男性检出率更高，以下呼吸道感染为主。更多还原

【Abstract】 Objective To analyze the annual detection results and epidemiological distribution of carbapenem-resistant Klebsiella pneumoniae(CRKP) across different infection types,to provide reference for formulating comprehensive prevention and control measures for CRKP in Quanzhou. Methods A retrospective survey was conducted to collect clinical data of patients diagnosed with Klebsiella pneumoniae infection admitted to the 2 nd Affiliated Hospital of Fujian Medical University from January 2017 to December 2023. The patients were classified into CRKP infection group and carbapenem-susceptible Klebsiella pneumoniae(CSKP) infection group based on drug susceptibility. The trends of CRKP detection and infection were explored.Results A total of 3 444 patients with Klebsiella pneumoniae infection were included from 2017 to 2023,among whom 230 were infection with CRKP,with an positive rate of 6.68%. The positive rate of CRKP in hospital-acquired infection was 7.46%(73/979),while that in community-acquired infection was 6.37%(157/2465). The annual positive rates of CRKP in both hospital-acquired infection （χ~2=52.019,P<0.000 1） and community-acquired infection （χ~2=143.113,P<0.000 1） showed an upward trend,with statistically significant differences. The positive rate of CRKP in males(7.46%) was higher than that in females(5.10%),the difference was statistically significant （χ~2=6.822,P=0.009）. The middle-aged group(45-60 years old) had the highest CRKP positive rate(6.12%). The distribution of CRKP infection sites differed between hospital-acquired and community-acquired infections,there was no significant difference in the distribution of CRKP across various infection sites in hospital-acquired infections（χ~2=34.441,P=0.077）,whereas a significant difference was observed in community-acquired infection （χ~2=88.132,P<0.000 1）. Lower respiratory tract infection was the most common type in community-acquired infection,with positive rate of 9.52%. Conclusion The detection positive rates of CRKP in both hospital and community settings showed an annual upward trend,with higher rates in males and lower respiratory tract infection as the predominant type.更多还原