Objective To characterize the clinical and microbiological outcomes of infections caused by KPC -producing Enterobacteriaceae. Methods The Enterobacteriaceae isolates were collected from our hospital from January to December of 2011. The blaKPC was identified by PCR and sequencing analysis. The MICs of carbapenems were determined using the CLSI broth dilution method. The clinical data of patients infectd with KPC carbapenemase-producing Enterobacteriaceae were also reviewed. Results A total of 18 KPC-producing srains of Enterobacteriaceae were isolated in 2011, 15 of which were Klebsiella pneumoniae, 2 Escherichia coli, and 1 Enterobacteraerogenes. Beta-lactams were used in 90% of the patients, and carbapenems use in 70% of the patients prior to isolation of KPC-positive strains. All the KPC-positive isoltates were resistant to cepha-losporins and carbapenems. All the isolates were susceptible to tigecycline, and 60% of the isolates were susceptible to amika-cin. After treatment, 7 (43. 8%) patients died. Conclusions The prevalence of KPC -producing Enterobacteriaceae infections warrants rigorous infection control measures to prevent the dissemination and appropriate antimicrobial use in clinical practice.%目的 研究分析产KPC型碳青霉烯酶肠杆菌科细菌感染的临床和微生物学特点.方法 收集2011年1-12月武警总医院18株产KPC酶的肠杆菌科细菌,使用PCR和测序的方法对菌株进行鉴定,用微量肉汤稀释法检测其对常用抗菌药物的耐药性,并对产碳青霉烯酶肺炎克雷伯菌感染的病例临床资料进行调查分析.结果 2011年从临床送检的标本中,通过表型鉴定和PCR检测,共分离出产KPC型碳青霉烯酶细菌18株,其中肺炎克雷伯菌13株,大肠埃希菌4株,产气肠杆菌1株.90％患者在产KPC型碳青霉烯酶肠杆菌科细菌分离之前,使用过头孢菌素类(包括第二、三、四代头孢菌素)、头霉素、氨曲南和β内酰胺酶抑制剂复方制剂,70％患者使用过碳青霉烯类抗生素.所有菌株对头孢菌素类和碳青霉烯类抗生素耐药,对阿米卡星的敏感率为60.0％,对替加环素的敏感率为100％.经过治疗后,7例患者死亡,病死率43.8％.结论 产KPC型碳青霉烯酶肠杆菌科细菌的出现,提示临床上应严格控制抗生素的使用,加强医院感染控制措施,防止和减少此类耐药菌在医院内的传播.
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