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Article(id=1194613945689415852, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1194613942065533315, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.1785.2025.0226, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1730822400000, receivedDateStr=2024-11-06, revisedDate=null, revisedDateStr=null, acceptedDate=1735488000000, acceptedDateStr=2024-12-30, onlineDate=1762747759505, onlineDateStr=2025-11-10, pubDate=1743091200000, pubDateStr=2025-03-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1762747759505, onlineIssueDateStr=2025-11-10, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1762747759505, creator=13701087609, updateTime=1762747759505, updator=13701087609, issue=Issue{id=1194613942065533315, tenantId=1146029695717560320, journalId=1189873630562394117, year='2025', volume='50', issue='3', pageStart='245', pageEnd='365', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1762747758641, creator=13701087609, updateTime=1762749141462, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1194619742100103439, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1194613942065533315, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1194619742100103440, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1194613942065533315, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=292, endPage=300, ext={EN=ArticleExt(id=1194613945966239921, articleId=1194613945689415852, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Clinical characteristics of Klebsiella pneumoniae in adult intensive care unit: a nationwide multi-center cohort study in China, columnId=1190310109000602400, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Clinical Research, runingTitle=null, highlight=null, articleAbstract=

Objective To analyze the epidemiological distribution, microbiological characteristics, drug-resistance status, and risk factors for mortality in adult intensive care unit (ICU) patients with Klebsiella pneumoniae infection. Methods This multi-center prospective cohort study included ICU patients with suspected infection from 67 hospitals across 16 Chinese provinces/municipalities between July 1, 2021 and December 31, 2022. Clinical data and microbiological results were collected, and patients were divided into survival and non-survival groups according to their survival status and drug-resistance situation. Risk factors for mortality and drug resistance in ICU patients with Klebsiella pneumonia infection were determined through univariate and multivariate logistic regression analyses. Results A total of 2964 ICU-infected patients were enrolled, with 12 175 microbial specimens submitted for testing. Among these, 487 specimens tested positive for Klebsiella pneumoniae. Ultimately, 314 patients with Klebsiella pneumoniae infection were identified, primarily from lung infections, with a drug-resistance rate of 78.3%. The in-hospital mortality rate of ICU patients infected with Klebsiella pneumoniae was 19.8%. Univariate and multivariate logistic regression analyses revealed that older age (P=0.027), high drug-resistance rate (P=0.028), and low clinical-effectiveness rate (P<0.001) were independent risk factors for mortality in ICU patients infected with Klebsiella pneumoniae. Drug-resistance analysis showed that, compared with non-resistant cases, ICU patients with drug-resistant Klebsiella pneumoniae infection had lower pathogen-clearance rates (P=0.003), clinical-effectiveness rates (P=0.004), and antibiotic-effectiveness rates (P<0.010), and higher mortality rates (P=0.006). Patients with Klebsiella pneumoniae abdominal infection (P=0.003) and urinary tract infection (P=0.007) had higher drug-resistance incidences. There were no statistically significant differences in clinical-effectiveness rate, Klebsiella pneumoniae clearance, drug-resistance incidence, mortality rate, or hospital-stay length between patients with lung infection and those with non-lung infection of Klebsiella pneumoniae (P>0.05). Compared with patients with non-bloodstream infection, patients with bloodstream infection of Klebsiella pneumoniae had lower clinical-effectiveness rates (P=0.027) and higher mortality rates (P=0.021). Conclusions Older age, high drug-resistance rate, and low clinical-effectiveness rate are independent risk factors for mortality in ICU patients infected with Klebsiella pneumoniae. ICU patients with bloodstream infection of Klebsiella pneumoniae may have lower clinical-effectiveness rates and higher mortality rates. ICU patients with abdominal and urinary tract infections caused by Klebsiella pneumoniae are more likely to develop drug resistance.

, correspAuthors=Hui-Ying Zhao, authorNote=null, correspAuthorsNote=
E-mail:
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目的 分析重症监护病房(ICU)住院患者肺炎克雷伯菌感染的分布、微生物学特点、耐药情况和死亡危险因素。方法 本研究为多中心前瞻性队列研究。收集2021年7月1日－2022年12月31日全国16个省(直辖市)67家有ICU科室的医院在ICU住院期间可疑感染患者的临床资料及微生物检测结果，根据患者的存活情况和耐药情况进行分组。采用单因素和多因素logistic回归分析ICU肺炎克雷伯菌感染患者的死亡危险因素和耐药危险因素。结果 共纳入2964例ICU感染患者，送检微生物标本12 175份，检出肺炎克雷伯菌487份；最终确定314例肺炎克雷伯菌感染患者，主要来源于肺部感染，耐药率为78.3%。在ICU住院期间，肺炎克雷伯菌感染患者的病死率为19.8%。单因素和多因素logistic回归分析显示，年龄大(P=0.027)、耐药率高(P=0.028)和临床有效率低(P<0.001)是ICU肺炎克雷伯菌感染患者死亡的独立危险因素。耐药分析显示，与未发生耐药者比较，发生耐药的ICU肺炎克雷伯菌感染患者的致病菌清除率(P=0.003)、临床有效率(P=0.004)、抗生素有效率(P<0.010)较低，病死率较高(P=0.006)；肺炎克雷伯菌腹腔感染(P=0.003)和尿路感染(P=0.007)者的耐药发生率较高。肺部感染肺炎克雷伯菌患者的临床有效率、肺炎克雷伯菌清除情况、耐药率、病死率及住院时间与非肺部感染肺炎克雷伯菌者比较差异无统计学意义(P>0.05)。与非血流感染者比较，血流感染肺炎克雷伯菌的患者临床有效率较低(P=0.027)、病死率较高(P=0.021)。结论 年龄大、耐药率高和临床有效率低是ICU肺炎克雷伯菌感染患者死亡的独立危险因素。血流感染肺炎克雷伯菌的ICU患者临床有效率较低、病死率较高。腹腔及尿路感染肺炎克雷伯菌的ICU患者更易发生耐药。

, correspAuthors=赵慧颖, authorNote=null, correspAuthorsNote=
赵慧颖，E-mail：
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杨曙光，医学博士，主治医师，主要从事脓毒症及脓毒症休克治疗方面的研究

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杨曙光，医学博士，主治医师，主要从事脓毒症及脓毒症休克治疗方面的研究

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杨曙光，医学博士，主治医师，主要从事脓毒症及脓毒症休克治疗方面的研究

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journalId=1189873630562394117, articleId=1194613945689415852, language=CN, orderNo=3, keyword=肺炎克雷伯菌)], refs=[Reference(id=1194634169461478377, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=22, issue=8, pageStart=4042, pageEnd=null, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=Arato V, Raso MM, Gasperini G, journalName=Int J Mol Sci, refType=null, unstructuredReference=Arato V, Raso MM, Gasperini G, et al. Prophylaxis and treatment against Klebsiella pneumoniae: current insights on this emerging anti-microbial resistant global threat[J]. Int J Mol Sci, 2021, 22(8): 4042., articleTitle=Prophylaxis and treatment against Klebsiella pneumoniae: current insights on this emerging anti-microbial resistant global threat, refAbstract=null), Reference(id=1194634169549558762, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2022, volume=11, issue=1, pageStart=841, pageEnd=849, url=null, language=null, rfNumber=[2], rfOrder=1, authorNames=Yang X, Sun Q, Li J, journalName=Emerg Microbes Infect, refType=null, unstructuredReference=Yang X, Sun Q, Li J, et al. Molecular epidemiology of carbapenem-resistant hypervirulent Klebsiella pneumoniae in China[J]. Emerg Microbes Infect, 2022, 11(1): 841-849., articleTitle=Molecular epidemiology of carbapenem-resistant hypervirulent Klebsiella pneumoniae in China, refAbstract=null), Reference(id=1194634169616667627, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2022, volume=22, issue=3, pageStart=401, pageEnd=412, url=null, language=null, rfNumber=[3], rfOrder=2, authorNames=Wang M, Earley M, Chen L, journalName=Lancet Infect Dis, refType=null, unstructuredReference=Wang M, Earley M, Chen L, et al. Clinical outcomes and bacterial characteristics of carbapenem-resistant Klebsiella pneumoniae complex among patients from different global regions (CRACKLE-2): a prospective, multicentre, cohort study[J]. Lancet Infect Dis, 2022, 22(3): 401-412., articleTitle=Clinical outcomes and bacterial characteristics of carbapenem-resistant Klebsiella pneumoniae complex among patients from different global regions (CRACKLE-2): a prospective, multicentre, cohort study, refAbstract=null), Reference(id=1194634169679582188, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=29, issue=1, pageStart=65, pageEnd=83, url=null, language=null, rfNumber=[4], rfOrder=3, authorNames=Yang X, Dong N, Chan EW, journalName=Trends Microbiol, refType=null, unstructuredReference=Yang X, Dong N, Chan EW, et al. Carbapenem resistance-encoding and virulence-encoding conjugative plasmids in Klebsiella pneumoniae[J]. Trends Microbiol, 2021, 29(1): 65-83., articleTitle=Carbapenem resistance-encoding and virulence-encoding conjugative plasmids in Klebsiella pneumoniae, refAbstract=null), Reference(id=1194634169738302445, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=11, issue=1, pageStart=6491, pageEnd=null, url=null, language=null, rfNumber=[5], rfOrder=4, authorNames=Spadar A, Perdigão J, Phelan J, journalName=Sci Rep, refType=null, unstructuredReference=Spadar A, Perdigão J, Phelan J, et al. Methylation analysis of Klebsiella pneumoniae from Portuguese hospitals[J]. Sci Rep, 2021, 11(1): 6491., articleTitle=Methylation analysis of Klebsiella pneumoniae from Portuguese hospitals, refAbstract=null), Reference(id=1194634169805411310, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=15, issue=3, pageStart=404, pageEnd=414, url=null, language=null, rfNumber=[6], rfOrder=5, authorNames=Sleiman A, Awada B, Mocadie M, journalName=J Infect Dev Ctries, refType=null, unstructuredReference=Sleiman A, Awada B, Mocadie M, et al. An unequivocal superbug: PDR Klebsiella pneumoniae with an arsenal of resistance and virulence factor genes[J]. J Infect Dev Ctries, 2021, 15(3): 404-414., articleTitle=An unequivocal superbug: PDR Klebsiella pneumoniae with an arsenal of resistance and virulence factor genes, refAbstract=null), Reference(id=1194634169859937263, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=92, issue=null, pageStart=104915, pageEnd=null, url=null, language=null, rfNumber=[7], rfOrder=6, authorNames=Bowen T, Yingang X, Junhong L, journalName=Infect Genet Evol, refType=null, unstructuredReference=Bowen T, Yingang X, Junhong L, et al. Pressure response of carbapenems Klebsiella pneumoniae under antibiotic stress[J]. Infect Genet Evol, 2021, 92: 104915., articleTitle=Pressure response of carbapenems Klebsiella pneumoniae under antibiotic stress, refAbstract=null), Reference(id=1194634169927046128, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=21, issue=1, pageStart=366, pageEnd=null, url=null, language=null, rfNumber=[8], rfOrder=7, authorNames=Liu Y, Liu Y, Dai J, journalName=BMC Infect Dis, refType=null, unstructuredReference=Liu Y, Liu Y, Dai J, et al. Klebsiella pneumoniae pneumonia in patients with rheumatic autoimmune diseases: clinical characteristics, antimicrobial resistance and factors associated with extended-spectrum β-lactamase production[J]. BMC Infect Dis, 2021, 21(1): 366., articleTitle=Klebsiella pneumoniae pneumonia in patients with rheumatic autoimmune diseases: clinical characteristics, antimicrobial resistance and factors associated with extended-spectrum β-lactamase production, refAbstract=null), Reference(id=1194634169994154993, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=9, issue=2, pageStart=271, pageEnd=null, url=null, language=null, rfNumber=[9], rfOrder=8, authorNames=Lee YJ, Huang CH, Ilsan NA, journalName=Microorganisms, refType=null, unstructuredReference=Lee YJ, Huang CH, Ilsan NA, et al. Molecular epidemiology and characterization of carbapenem-resistant Klebsiella pneumoniae isolated from urine at a teaching hospital in Taiwan[J]. Microorganisms, 2021, 9(2): 271., articleTitle=Molecular epidemiology and characterization of carbapenem-resistant Klebsiella pneumoniae isolated from urine at a teaching hospital in Taiwan, refAbstract=null), Reference(id=1194634171122422770, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2016, volume=5, issue=1, pageStart=1892, pageEnd=null, url=null, language=null, rfNumber=[10], rfOrder=9, authorNames=Durdu B, Hakyemez IN, Bolukcu S, journalName=Springerplus, refType=null, unstructuredReference=Durdu B, Hakyemez IN, Bolukcu S, et al. Mortality markers in nosocomial Klebsiella pneumoniae bloodstream infection[J]. Springerplus, 2016, 5(1): 1892., articleTitle=Mortality markers in nosocomial Klebsiella pneumoniae bloodstream infection, refAbstract=null), Reference(id=1194634171185337331, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=73, issue=9, pageStart=1664, pageEnd=1676, url=null, language=null, rfNumber=[11], rfOrder=10, authorNames=Tumbarello M, Raffaelli F, Giannella M, journalName=Clin Infect Dis, refType=null, unstructuredReference=Tumbarello M, Raffaelli F, Giannella M, et al. Ceftazidime-avibactam use for Klebsiella pneumoniae carbapenemase-producing K. pneumoniae infections: a retrospective observational multicenter study[J]. Clin Infect Dis, 2021, 73(9): 1664-1676., articleTitle=Ceftazidime-avibactam use for Klebsiella pneumoniae carbapenemase-producing K. pneumoniae infections: a retrospective observational multicenter study, refAbstract=null), Reference(id=1194634171302777844, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=100, issue=14, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[12], rfOrder=11, authorNames=Lima Rodríguez O, Sousa A, Pérez-Rodríguez MT, journalName=Medicine (Baltimore), refType=null, unstructuredReference=Lima Rodríguez O, Sousa A, Pérez-Rodríguez MT, et al. Mortality-related factors in patients with OXA-48 carbapenemase-producing Klebsiella pneumoniae bacteremia[J]. Medicine (Baltimore), 2021, 100(14): e24880., articleTitle=Mortality-related factors in patients with OXA-48 carbapenemase-producing Klebsiella pneumoniae bacteremia, refAbstract=null), Reference(id=1194634171386663925, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2023, volume=13, issue=null, pageStart=1157010, pageEnd=null, url=null, language=null, rfNumber=[13], rfOrder=12, authorNames=Li D, Huang X, Rao H, journalName=Front Cell Infect Microbiol, refType=null, unstructuredReference=Li D, Huang X, Rao H, et al. Klebsiella pneumoniae bacteremia mortality: a systematic review and meta-analysis[J]. Front Cell Infect Microbiol, 2023, 13: 1157010., articleTitle=Klebsiella pneumoniae bacteremia mortality: a systematic review and meta-analysis, refAbstract=null), Reference(id=1194634171449578486, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2016, volume=315, issue=8, pageStart=762, pageEnd=774, url=null, language=null, rfNumber=[14], rfOrder=13, authorNames=Seymour CW, Liu VX, Iwashyna TJ, journalName=JAMA, refType=null, unstructuredReference=Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (Sepsis-3)[J]. JAMA, 2016, 315(8): 762-774., articleTitle=Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (Sepsis-3), refAbstract=null), Reference(id=1194634171512493047, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2017, volume=43, issue=3, pageStart=304, pageEnd=377, url=null, language=null, rfNumber=[15], rfOrder=14, authorNames=Rhodes A, Evans LE, Alhazzani W, journalName=Intensive Care Med, refType=null, unstructuredReference=Rhodes A, Evans LE, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016[J]. Intensive Care Med, 2017, 43(3): 304-377., articleTitle=Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016, refAbstract=null), Reference(id=1194634171583796216, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=121, issue=6, pageStart=3235, pageEnd=3237, url=null, language=null, rfNumber=[16], rfOrder=15, authorNames=Kurt Yilmaz N, Schiffer CA, journalName=Chem Rev, refType=null, unstructuredReference=Kurt Yilmaz N, Schiffer CA. Introduction: drug resistance[J]. Chem Rev, 2021, 121(6): 3235-3237., articleTitle=Introduction: drug resistance, refAbstract=null), Reference(id=1194634171680265209, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=63, issue=8, pageStart=676, pageEnd=685, url=null, language=null, rfNumber=[17], rfOrder=16, authorNames=Shukla A, Jani N, Polra M, journalName=Mol Biotechnol, refType=null, unstructuredReference=Shukla A, Jani N, Polra M, et al. CRISPR: the multidrug resistance endgame?[J]. Mol Biotechnol, 2021, 63(8): 676-685., articleTitle=CRISPR: the multidrug resistance endgame?, refAbstract=null), Reference(id=1194634171764151290, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2012, volume=18, issue=3, pageStart=268, pageEnd=81, url=null, language=null, rfNumber=[18], rfOrder=17, authorNames=Magiorakos A P, Srinivasan A, Carey R B, journalName=Clin Microbiol Infect, refType=null, unstructuredReference=Magiorakos A P, Srinivasan A, Carey R B, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance[J]. Clin Microbiol Infect, 2012, 18(3): 268-81., articleTitle=Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance, refAbstract=null), Reference(id=1194634171864814587, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=10, issue=1, pageStart=541, pageEnd=558, url=null, language=null, rfNumber=[19], rfOrder=18, authorNames=Maraolo AE, Corcione S, Grossi A, journalName=Infect Dis Ther, refType=null, unstructuredReference=Maraolo AE, Corcione S, Grossi A, et al. The impact of carbapenem resistance on mortality in patients with Klebsiella pneumoniae bloodstream infection: an individual patient data meta-analysis of 1952 patients[J]. Infect Dis Ther, 2021, 10(1): 541-558., articleTitle=The impact of carbapenem resistance on mortality in patients with Klebsiella pneumoniae bloodstream infection: an individual patient data meta-analysis of 1952 patients, refAbstract=null), Reference(id=1194634171927729148, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=34, issue=2, pageStart=135, pageEnd=141, url=null, language=null, rfNumber=[20], rfOrder=19, authorNames=Furman CD, Leinenbach A, Usher R, journalName=Curr Opin Infect Dis, refType=null, unstructuredReference=Furman CD, Leinenbach A, Usher R, et al. Pneumonia in older adults[J]. Curr Opin Infect Dis, 2021, 34(2): 135-141., articleTitle=Pneumonia in older adults, refAbstract=null), Reference(id=1194634171999032317, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2024, volume=72, issue=8, pageStart=2613, pageEnd=2614, url=null, language=null, rfNumber=[21], rfOrder=20, authorNames=Kow CS, Ramachandram DS, Hasan SS, journalName=J Am Geriatr Soc, refType=null, unstructuredReference=Kow CS, Ramachandram DS, Hasan SS, et al. Insights into COVID-19 pneumonia among older adults: understanding aspiration and risk factors for mortality[J]. J Am Geriatr Soc, 2024, 72(8): 2613-2614., articleTitle=Insights into COVID-19 pneumonia among older adults: understanding aspiration and risk factors for mortality, refAbstract=null), Reference(id=1194634172087112702, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=7, issue=1, pageStart=25, pageEnd=null, url=null, language=null, rfNumber=[22], rfOrder=21, authorNames=Torres A, Cilloniz C, Niederman MS, journalName=Nat Rev Dis Primers, refType=null, unstructuredReference=Torres A, Cilloniz C, Niederman MS, et al. Pneumonia[J]. Nat Rev Dis Primers, 2021, 7(1): 25., articleTitle=Pneumonia, refAbstract=null), Reference(id=1194634172150027263, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2017, volume=94, issue=3, pageStart=299, pageEnd=311, url=null, language=null, rfNumber=[23], rfOrder=22, authorNames=Almirall J, Serra-Prat M, Bolíbar I, journalName=Respiration, refType=null, unstructuredReference=Almirall J, Serra-Prat M, Bolíbar I, et al. Risk factors for community-acquired pneumonia in adults: a systematic review of observational studies[J]. Respiration, 2017, 94(3): 299-311., articleTitle=Risk factors for community-acquired pneumonia in adults: a systematic review of observational studies, refAbstract=null), Reference(id=1194634172225524736, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=21, issue=1, pageStart=314, pageEnd=null, url=null, language=null, rfNumber=[24], rfOrder=23, authorNames=Kang Y, Fang X, Wang D, journalName=BMC Infect Dis, refType=null, unstructuredReference=Kang Y, Fang X, Wang D, et al. Activity of daily living upon admission is an independent predictor of in-hospital mortality in older patients with community-acquired pneumonia[J]. BMC Infect Dis, 2021, 21(1): 314., articleTitle=Activity of daily living upon admission is an independent predictor of in-hospital mortality in older patients with community-acquired pneumonia, refAbstract=null), Reference(id=1194634172288438272, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=21, issue=2, pageStart=226, pageEnd=240, url=null, language=null, rfNumber=[25], rfOrder=24, authorNames=Bassetti M, Echols R, Matsunaga Y, journalName=Lancet Infect Dis, refType=null, unstructuredReference=Bassetti M, Echols R, Matsunaga Y, et al. Efficacy and safety of cefiderocol or best available therapy for the treatment of serious infections caused by carbapenem-resistant Gram-negative bacteria (CREDIBLE-CR): a randomised, open-label, multicentre, pathogen-focused, descriptive, phase 3 trial[J]. Lancet Infect Dis, 2021, 21(2): 226-240., articleTitle=Efficacy and safety of cefiderocol or best available therapy for the treatment of serious infections caused by carbapenem-resistant Gram-negative bacteria (CREDIBLE-CR): a randomised, open-label, multicentre, pathogen-focused, descriptive, phase 3 trial, refAbstract=null), Reference(id=1194634172351352833, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=12, issue=null, pageStart=642484, pageEnd=null, url=null, language=null, rfNumber=[26], rfOrder=25, authorNames=Zhu J, Wang T, Chen L, journalName=Front Microbiol, refType=null, unstructuredReference=Zhu J, Wang T, Chen L, et al. Virulence factors in hypervirulent Klebsiella pneumoniae[J]. Front Microbiol, 2021, 12: 642484., articleTitle=Virulence factors in hypervirulent Klebsiella pneumoniae, refAbstract=null), Reference(id=1194634172410073090, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=10, issue=1, pageStart=700, pageEnd=709, url=null, language=null, rfNumber=[27], rfOrder=26, authorNames=Yang Y, Yang Y, Chen G, journalName=Emerg Microbes Infect, refType=null, unstructuredReference=Yang Y, Yang Y, Chen G, et al. Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in China[J]. Emerg Microbes Infect, 2021, 10(1): 700-709., articleTitle=Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in China, refAbstract=null), Reference(id=1194634172472987651, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=14, issue=null, pageStart=1855, pageEnd=1863, url=null, language=null, rfNumber=[28], rfOrder=27, authorNames=Chen J, Hu C, Wang R, journalName=Infect Drug Resist, refType=null, unstructuredReference=Chen J, Hu C, Wang R, et al. Shift in the dominant sequence type of carbapenem-resistant Klebsiella pneumoniae bloodstream infection from ST11 to ST15 at a medical center in NorthEast China, 2015-2020[J]. Infect Drug Resist, 2021, 14: 1855-1863., articleTitle=Shift in the dominant sequence type of carbapenem-resistant Klebsiella pneumoniae bloodstream infection from ST11 to ST15 at a medical center in NorthEast China, 2015-2020, refAbstract=null), Reference(id=1194634172531707908, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2023, volume=16, issue=null, pageStart=6767, pageEnd=6779, url=null, language=null, rfNumber=[29], rfOrder=28, authorNames=Zhou C, Sun L, Li H, journalName=Infect Drug Resist, refType=null, unstructuredReference=Zhou C, Sun L, Li H, et al. Risk factors and mortality of elderly patients with hospital-acquired pneumonia of carbapenem-resistant Klebsiella pneumoniae infection[J]. Infect Drug Resist, 2023, 16: 6767-6779., articleTitle=Risk factors and mortality of elderly patients with hospital-acquired pneumonia of carbapenem-resistant Klebsiella pneumoniae infection, refAbstract=null), Reference(id=1194634172590428165, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=33, issue=2, pageStart=122, pageEnd=127, url=null, language=null, rfNumber=[30], rfOrder=29, authorNames=Gallegos-Miranda V, Garza-Ramos U, Bolado-Martínez E, journalName=J Chemother, refType=null, unstructuredReference=Gallegos-Miranda V, Garza-Ramos U, Bolado-Martínez E, et al. ESBL-producing Escherichia coli and Klebsiella pneumoniae from health-care institutions in Mexico[J]. J Chemother, 2021, 33(2): 122-127., articleTitle=ESBL-producing Escherichia coli and Klebsiella pneumoniae from health-care institutions in Mexico, refAbstract=null), Reference(id=1194634172665925638, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=10, issue=1, pageStart=1129, pageEnd=1136, url=null, language=null, rfNumber=[31], rfOrder=30, authorNames=Jin X, Chen Q, Shen F, journalName=Emerg Microbes Infect, refType=null, unstructuredReference=Jin X, Chen Q, Shen F, et al. Resistance evolution of hypervirulent carbapenem-resistant Klebsiella pneumoniae ST11 during treatment with tigecycline and polymyxin[J]. Emerg Microbes Infect, 2021, 10(1): 1129-1136., articleTitle=Resistance evolution of hypervirulent carbapenem-resistant Klebsiella pneumoniae ST11 during treatment with tigecycline and polymyxin, refAbstract=null), Reference(id=1194634172720451591, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=78, issue=6, pageStart=2317, pageEnd=2323, url=null, language=null, rfNumber=[32], rfOrder=31, authorNames=Robatjazi S, Nikkhahi F, Niazadeh M, journalName=Curr Microbiol, refType=null, unstructuredReference=Robatjazi S, Nikkhahi F, Niazadeh M, et al. Phenotypic identification and genotypic characterization of plasmid-mediated AmpC β‑lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates in Iran[J]. Curr Microbiol, 2021, 78(6): 2317-2323., articleTitle=Phenotypic identification and genotypic characterization of plasmid-mediated AmpC β‑lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates in Iran, refAbstract=null), Reference(id=1194634172804337672, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=146, issue=4, pageStart=1421, pageEnd=1429, url=null, language=null, rfNumber=[33], rfOrder=32, authorNames=Suleiman M, Abu-Aqil G, Sharaha U, journalName=Analyst, refType=null, unstructuredReference=Suleiman M, Abu-Aqil G, Sharaha U, et al. Rapid detection of Klebsiella pneumoniae producing extended spectrum β lactamase enzymes by infrared microspectroscopy and machine learning algorithms[J]. Analyst, 2021, 146(4): 1421-1429., articleTitle=Rapid detection of Klebsiella pneumoniae producing extended spectrum β lactamase enzymes by infrared microspectroscopy and machine learning algorithms, refAbstract=null), Reference(id=1194634172871446537, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=10, issue=1, pageStart=67, pageEnd=null, url=null, language=null, rfNumber=[34], rfOrder=33, authorNames=Hernández-García M, Sánchez-López J, Martínez-García L, journalName=Pathogens, refType=null, unstructuredReference=Hernández-García M, Sánchez-López J, Martínez-García L, et al. Emergence of the new KPC-49 variant conferring an ESBL phenotype with resistance to ceftazidime-avibactam in the ST131-H30R1 Escherichia coli high-risk clone[J]. Pathogens, 2021, 10(1): 67., articleTitle=Emergence of the new KPC-49 variant conferring an ESBL phenotype with resistance to ceftazidime-avibactam in the ST131-H30R1 Escherichia coli high-risk clone, refAbstract=null), Reference(id=1194634172938555402, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2024, volume=22, issue=1-3, pageStart=25, pageEnd=43, url=null, language=null, rfNumber=[35], rfOrder=34, authorNames=Di Pilato V, Pollini S, Miriagou V, journalName=Expert Rev Anti Infect Ther, refType=null, unstructuredReference=Di Pilato V, Pollini S, Miriagou V, et al. Carbapenem-resistant Klebsiella pneumoniae: the role of plasmids in emergence, dissemination, and evolution of a major clinical challenge[J]. Expert Rev Anti Infect Ther, 2024, 22(1-3): 25-43., articleTitle=Carbapenem-resistant Klebsiella pneumoniae: the role of plasmids in emergence, dissemination, and evolution of a major clinical challenge, refAbstract=null), Reference(id=1194634173005664267, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2020, volume=20, issue=6, pageStart=731, pageEnd=741, url=null, language=null, rfNumber=[36], rfOrder=35, authorNames=van Duin D, Arias CA, Komarow L, journalName=Lancet Infect Dis, refType=null, unstructuredReference=van Duin D, Arias CA, Komarow L, et al. Molecular and clinical epidemiology of carbapenem-resistant Enterobacterales in the USA (CRACKLE-2): a prospective cohort study[J]. Lancet Infect Dis, 2020, 20(6): 731-741., articleTitle=Molecular and clinical epidemiology of carbapenem-resistant Enterobacterales in the USA (CRACKLE-2): a prospective cohort study, refAbstract=null), Reference(id=1194634173076967436, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=22, issue=1, pageStart=301, pageEnd=null, url=null, language=null, rfNumber=[37], rfOrder=36, authorNames=Stewart AG, Harris PNA, Chatfield MD, journalName=Trials, refType=null, unstructuredReference=Stewart AG, Harris PNA, Chatfield MD, et al. Ceftolozane-tazobactam versus meropenem for definitive treatment of bloodstream infection due to extended-spectrum beta-lactamase (ESBL) and AmpC-producing Enterobacterales ("MERINO-3"): study protocol for a multicentre, open-label randomised non-inferiority trial[J]. Trials, 2021, 22(1): 301., articleTitle=Ceftolozane-tazobactam versus meropenem for definitive treatment of bloodstream infection due to extended-spectrum beta-lactamase (ESBL) and AmpC-producing Enterobacterales ("MERINO-3"): study protocol for a multicentre, open-label randomised non-inferiority trial, refAbstract=null), Reference(id=1194634173169242125, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2021, volume=14, issue=null, pageStart=731, pageEnd=742, url=null, language=null, rfNumber=[38], rfOrder=37, authorNames=Zhou C, Jin L, Wang Q, journalName=Infect Drug Resist, refType=null, unstructuredReference=Zhou C, Jin L, Wang Q, et al. Bloodstream infections caused by carbapenem-resistant Enterobacterales: risk factors for mortality, antimicrobial therapy and treatment outcomes from a prospective multicenter study[J]. Infect Drug Resist, 2021, 14: 731-742., articleTitle=Bloodstream infections caused by carbapenem-resistant Enterobacterales: risk factors for mortality, antimicrobial therapy and treatment outcomes from a prospective multicenter study, refAbstract=null), Reference(id=1194634173320237070, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, doi=null, pmid=null, pmcid=null, year=2024, volume=56, issue=12, pageStart=1021, pageEnd=1030, url=null, language=null, rfNumber=[39], rfOrder=38, authorNames=Xiao S, Zhou S, Cao H, journalName=Infect Dis (Lond), refType=null, unstructuredReference=Xiao S, Zhou S, Cao H, et al. Incidence, antimicrobial resistance and mortality of Klebsiella pneumoniae bacteraemia in Shanghai, China, 2018-2022[J]. Infect Dis (Lond), 2024, 56(12): 1021-1030., articleTitle=Incidence, antimicrobial resistance and mortality of Klebsiella pneumoniae bacteraemia in Shanghai, China, 2018-2022, refAbstract=null)], funds=[Fund(id=1194634169214014439, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, awardId=82202366, language=EN, fundingSource=National Natural Science Foundation of China(82202366), fundOrder=null, country=null), Fund(id=1194634169268540392, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, awardId=82202366, language=CN, fundingSource=国家自然科学基金(82202366), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1194634164759663527, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, xref=1, ext=[AuthorCompanyExt(id=1194634164768052136, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, companyId=1194634164759663527, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Department of Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China), AuthorCompanyExt(id=1194634164776440745, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, companyId=1194634164759663527, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1北京大学人民医院重症医学科，北京 100044)]), AuthorCompany(id=1194634164839355306, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, xref=2, ext=[AuthorCompanyExt(id=1194634164847743915, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, companyId=1194634164839355306, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China), AuthorCompanyExt(id=1194634164856132524, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, companyId=1194634164839355306, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2北京大学第三医院临床流行病学研究中心，北京 100191)]), AuthorCompany(id=1194634164923241389, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, xref=3, ext=[AuthorCompanyExt(id=1194634164931629998, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, companyId=1194634164923241389, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3Department of Critical Care Medicine, Peking University International Hospital, Beijing 102206, China), AuthorCompanyExt(id=1194634164935824303, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, companyId=1194634164923241389, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3北京大学国际医院重症医学科，北京　102206)])], figs=[ArticleFig(id=1194634168077358041, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, language=EN, label=Fig.1, caption=Flowchart of ICU patients infected with Klebsiella pneumoniae enrollment, figureFileSmall=1/8VrK14p6BMDefiC/nOWA==, figureFileBig=GGHB8ZKp1bnh78+7kYn67g==, tableContent=null), ArticleFig(id=1194634168148661210, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, language=CN, label=图1, caption=ICU肺炎克雷伯菌感染患者的纳入排除流程图

ICU. 重症监护病房

, figureFileSmall=1/8VrK14p6BMDefiC/nOWA==, figureFileBig=GGHB8ZKp1bnh78+7kYn67g==, tableContent=null), ArticleFig(id=1194634168228352987, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, language=EN, label=Tab.1, caption=

Distribution of ICU patients infected with Klebsiella pneumoniae in different regions

, figureFileSmall=null, figureFileBig=null, tableContent=
地区

ICU可疑

感染(例)

肺炎克雷伯菌

感染(例)

肺炎克雷伯菌

检出率(%)

华北地区779638.1
华东地区8118110.0
华中地区5627212.8
西南地区5598314.8
华南地区11854.2
西北地区104109.6
东北地区3100
), ArticleFig(id=1194634168287073244, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, language=CN, label=表1, caption=

不同地区ICU患者感染肺炎克雷伯菌的分布情况

, figureFileSmall=null, figureFileBig=null, tableContent=
地区

ICU可疑

感染(例)

肺炎克雷伯菌

感染(例)

肺炎克雷伯菌

检出率(%)

华北地区779638.1
华东地区8118110.0
华中地区5627212.8
西南地区5598314.8
华南地区11854.2
西北地区104109.6
东北地区3100
), ArticleFig(id=1194634168341599197, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, language=EN, label=Tab.2, caption=

Analysis of mortality of ICU patients infected with Klebsiella pneumoniae

, figureFileSmall=null, figureFileBig=null, tableContent=
项目存活组(n=252)死亡组(n=62)χ2/tP
女性[例(%)]62(24.6)21(33.9)2.1980.138
年龄(岁, $\bar{x}±s$)65.8±14.471.1±15.3-2.5590.110
高血压[例(%)]58(23.0)10(16.1)1.3910.238
糖尿病[例(%)]29(11.5)4(6.5)1.3530.245
冠心病[例(%)]15(6.0)1(1.6)1.9380.164
脑血管病[例(%)]70(27.8)20(32.3)0.4880.485
血液病[例(%)]9(3.6)3(4.8)0.2170.641
医院分级[例(%)]1.9720.578
三级甲等219(86.9)57(91.9)
三级乙等6(2.4)0
三级丙等6(2.4)1(1.6)
二级甲等21(8.3)4(6.5)
地区分布[例(%)]25.992<0.001
华北地区55(21.8)8(12.9)
华东地区75(29.8)6(9.7)
华中地区58(23.0)14(22.6)
西南地区52(20.6)31(50.0)
华南地区4(1.6)1(1.6)
西北地区8(3.2)2(3.2)
肺部感染[例(%)]195(77.4)47(75.8)0.0700.792
血流感染[例(%)]41(16.3)18(29.0)5.3110.021
腹腔感染[例(%)]14(5.6)03.6050.058
尿路感染[例(%)]13(5.2)7(11.3)3.1370.077
皮肤感染[例(%)]4(1.6)1(1.6)0.0000.988
颅内感染[例(%)]2(0.8)1(1.6)0.3530.552
耐药[例(%)]189(75.0)57(91.9)8.4110.004
多重耐药[例(%)]111(44.1)39(62.9)7.0900.008
临床有效[例(%)]216(85.7)12(19.4)110.178<0.001
致病菌清除情况[例(%)]47.899<0.001
未清除53(21.0)37(59.7)
清除77(30.6)3(4.8)
假定未清除9(3.6)5(8.1)
假定清除64(25.4)5(8.1)
部分清除49(19.4)25(40.3)
抗生素有效[例(%)]111(44.1)8(12.9)36.981<0.001
住院时间(d, $\bar{x}±s$)25.2±29.925.5±46.6-0.0650.949
), ArticleFig(id=1194634168417096670, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, language=CN, label=表2, caption=

ICU肺炎克雷伯菌感染患者死亡情况分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目存活组(n=252)死亡组(n=62)χ2/tP
女性[例(%)]62(24.6)21(33.9)2.1980.138
年龄(岁, $\bar{x}±s$)65.8±14.471.1±15.3-2.5590.110
高血压[例(%)]58(23.0)10(16.1)1.3910.238
糖尿病[例(%)]29(11.5)4(6.5)1.3530.245
冠心病[例(%)]15(6.0)1(1.6)1.9380.164
脑血管病[例(%)]70(27.8)20(32.3)0.4880.485
血液病[例(%)]9(3.6)3(4.8)0.2170.641
医院分级[例(%)]1.9720.578
三级甲等219(86.9)57(91.9)
三级乙等6(2.4)0
三级丙等6(2.4)1(1.6)
二级甲等21(8.3)4(6.5)
地区分布[例(%)]25.992<0.001
华北地区55(21.8)8(12.9)
华东地区75(29.8)6(9.7)
华中地区58(23.0)14(22.6)
西南地区52(20.6)31(50.0)
华南地区4(1.6)1(1.6)
西北地区8(3.2)2(3.2)
肺部感染[例(%)]195(77.4)47(75.8)0.0700.792
血流感染[例(%)]41(16.3)18(29.0)5.3110.021
腹腔感染[例(%)]14(5.6)03.6050.058
尿路感染[例(%)]13(5.2)7(11.3)3.1370.077
皮肤感染[例(%)]4(1.6)1(1.6)0.0000.988
颅内感染[例(%)]2(0.8)1(1.6)0.3530.552
耐药[例(%)]189(75.0)57(91.9)8.4110.004
多重耐药[例(%)]111(44.1)39(62.9)7.0900.008
临床有效[例(%)]216(85.7)12(19.4)110.178<0.001
致病菌清除情况[例(%)]47.899<0.001
未清除53(21.0)37(59.7)
清除77(30.6)3(4.8)
假定未清除9(3.6)5(8.1)
假定清除64(25.4)5(8.1)
部分清除49(19.4)25(40.3)
抗生素有效[例(%)]111(44.1)8(12.9)36.981<0.001
住院时间(d, $\bar{x}±s$)25.2±29.925.5±46.6-0.0650.949
), ArticleFig(id=1194634168492594143, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, language=EN, label=Tab.3, caption=

Distribution of mortality, drug resistance, clinical effect, and clearance for ICU patients infected with Klebsiella pneumoniae

, figureFileSmall=null, figureFileBig=null, tableContent=
地区肺炎克雷伯菌感染(例)死亡[例(%)]耐药[例(%)]临床有效[例(%)]致病菌清除[例(%)]
华北地区638(12.7)48(76.2)55(87.3)16(25.4)
华东地区816(7.4)51(63.0)70(86.4)27(33.3)
华中地区7214(19.4)61(84.7)51(70.8)21(29.2)
西南地区8331(37.3)76(91.6)40(48.2)11(13.3)
华南地区51(20.0)5(100.0)4(80.0)1(20.0)
西北地区102(20.0)5(50.0)8(80.0)4(40.0)
东北地区00000
), ArticleFig(id=1194634168593257440, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, language=CN, label=表3, caption=

不同地区ICU肺炎克雷伯菌感染患者的死亡、耐药、临床效果和致病菌清除情况分布

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地区肺炎克雷伯菌感染(例)死亡[例(%)]耐药[例(%)]临床有效[例(%)]致病菌清除[例(%)]
华北地区638(12.7)48(76.2)55(87.3)16(25.4)
华东地区816(7.4)51(63.0)70(86.4)27(33.3)
华中地区7214(19.4)61(84.7)51(70.8)21(29.2)
西南地区8331(37.3)76(91.6)40(48.2)11(13.3)
华南地区51(20.0)5(100.0)4(80.0)1(20.0)
西北地区102(20.0)5(50.0)8(80.0)4(40.0)
东北地区00000
), ArticleFig(id=1194634168664560609, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, language=EN, label=Tab.4, caption=

Analysis of drug resistance for ICU patients infected with Klebsiella pneumoniae

, figureFileSmall=null, figureFileBig=null, tableContent=
项目非耐药组(n=68)耐药组(n=96)多重耐药组(n=150)χ2/tP
女性[例(%)]16(23.5)24(25.0)43(28.7)0.7810.677
年龄(岁, $\bar{x}±s$)64.6±15.965.2±13.768.9±14.62.9440.054
高血压[例(%)]13(19.1)28(29.2)27(18.0)4.6320.098
糖尿病[例(%)]8(11.8)12(12.5)13(8.7)1.0600.589
冠心病[例(%)]4(5.9)3(3.1)9(6.0)1.1670.558
脑血管病[例(%)]21(30.9)29(30.2)40(26.7)0.5680.753
血液病[例(%)]2(2.9)6(6.3)4(2.7)2.2280.328
医院分级[例(%)]6.2440.396
三级甲等60(88.2)88(91.7)128(85.3)
三级乙等3(4.4)1(1.0)2(1.3)
三级丙等1(1.5)1(1.0)5(3.3)
二级甲等4(5.9)6(6.3)15(10.0)
地区分布[例(%)]37.846<0.001
华北地区15(22.1)25(26.0)(1)23(15.3)(1)(2)
华东地区30(44.1)25(26.0)26(17.3)
华中地区11(16.2)20(20.8)41(27.3)
西南地区7(10.3)23(24.0)53(35.3)
华南地区01(1.0)4(2.7)
西北地区5(7.4)2(2.1)3(2.0)
临床有效[例(%)]56(82.4)76(79.2)96(64.0)(1)(2)10.9120.004
致病菌清除情况[例(%)]23.5840.003
未清除14(20.6)23(24.0)53(35.3)(1)
清除25(36.8)32(33.3)23(15.3)
假定未清除3(4.4)5(5.2)6(4.0)
假定清除14(20.6)25(26.0)30(20.0)
部分清除12(17.7)11(11.5)38(25.3)
抗生素有效[例(%)]39(57.4)57(59.4)53(35.3)(1)(2)16.98<0.010
肺部感染[例(%)]56(82.4)70(72.9)116(77.3)2.0170.365
血流感染[例(%)]10(14.7)15(15.6)34(22.7)2.8510.240
腹腔感染[例(%)]2(2.9)10(10.4)(1)2(1.3)(2)11.8070.003
尿路感染[例(%)]0(0.0)4(4.2)(1)16(10.7)(1)(2)10.0520.007
皮肤感染[例(%)]1(1.5)1(1.0)3(2.0)0.3510.839
颅内感染[例(%)]003(2.0)3.3120.191
住院时间(d, $\bar{x}±s$)21.4±16.022.6±38.128.6±36.41.4880.227
死亡[例(%)]5(7.4)18(18.8)(1)39(26.0)(1)10.3530.006
), ArticleFig(id=1194634168752640994, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, language=CN, label=表4, caption=

ICU肺炎克雷伯菌感染患者的耐药情况分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目非耐药组(n=68)耐药组(n=96)多重耐药组(n=150)χ2/tP
女性[例(%)]16(23.5)24(25.0)43(28.7)0.7810.677
年龄(岁, $\bar{x}±s$)64.6±15.965.2±13.768.9±14.62.9440.054
高血压[例(%)]13(19.1)28(29.2)27(18.0)4.6320.098
糖尿病[例(%)]8(11.8)12(12.5)13(8.7)1.0600.589
冠心病[例(%)]4(5.9)3(3.1)9(6.0)1.1670.558
脑血管病[例(%)]21(30.9)29(30.2)40(26.7)0.5680.753
血液病[例(%)]2(2.9)6(6.3)4(2.7)2.2280.328
医院分级[例(%)]6.2440.396
三级甲等60(88.2)88(91.7)128(85.3)
三级乙等3(4.4)1(1.0)2(1.3)
三级丙等1(1.5)1(1.0)5(3.3)
二级甲等4(5.9)6(6.3)15(10.0)
地区分布[例(%)]37.846<0.001
华北地区15(22.1)25(26.0)(1)23(15.3)(1)(2)
华东地区30(44.1)25(26.0)26(17.3)
华中地区11(16.2)20(20.8)41(27.3)
西南地区7(10.3)23(24.0)53(35.3)
华南地区01(1.0)4(2.7)
西北地区5(7.4)2(2.1)3(2.0)
临床有效[例(%)]56(82.4)76(79.2)96(64.0)(1)(2)10.9120.004
致病菌清除情况[例(%)]23.5840.003
未清除14(20.6)23(24.0)53(35.3)(1)
清除25(36.8)32(33.3)23(15.3)
假定未清除3(4.4)5(5.2)6(4.0)
假定清除14(20.6)25(26.0)30(20.0)
部分清除12(17.7)11(11.5)38(25.3)
抗生素有效[例(%)]39(57.4)57(59.4)53(35.3)(1)(2)16.98<0.010
肺部感染[例(%)]56(82.4)70(72.9)116(77.3)2.0170.365
血流感染[例(%)]10(14.7)15(15.6)34(22.7)2.8510.240
腹腔感染[例(%)]2(2.9)10(10.4)(1)2(1.3)(2)11.8070.003
尿路感染[例(%)]0(0.0)4(4.2)(1)16(10.7)(1)(2)10.0520.007
皮肤感染[例(%)]1(1.5)1(1.0)3(2.0)0.3510.839
颅内感染[例(%)]003(2.0)3.3120.191
住院时间(d, $\bar{x}±s$)21.4±16.022.6±38.128.6±36.41.4880.227
死亡[例(%)]5(7.4)18(18.8)(1)39(26.0)(1)10.3530.006
), ArticleFig(id=1194634168840721379, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1194613945689415852, language=EN, label=Tab.5, caption=

Analysis of ICU patients with pulmonary infection with Klebsiella pneumoniae

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项目非肺部感染组(n=72)肺部感染组(n=242)χ2/tP
女性[例(%)]20(27.8)63(26.0)0.0870.768
年龄(岁, $\bar{x}±s$)65.5±14.967.2±14.70.2610.386
医院分级[例(%)]5.9040.116
三级甲等69(95.8)207(85.5)
三级乙等06(2.5)
三级丙等1(1.4)6(2.5)
二级甲等2(2.8)23(9.5)
地区分布[例(%)]21.1230.001
华北地区14(19.4)49(20.3)
华东地区12(16.7)69(28.5)
华中地区14(19.4)58(24.0)
西南地区22(30.6)61(25.2)
华南地区4(5.6)1(0.4)
西北地区6(8.3)4(1.7)
临床有效[例(%)]52(72.2)176(71.7)0.0070.933
致病菌清除情况[例(%)]1.4330.839
未清除17(23.6)73(30.2)
清除20(27.8)60(24.8)
假定未清除3(4.3)11(4.6)
假定清除18(25.0)51(21.1)
部分清除14(19.4)47(19.4)
抗生素有效[例(%)]38(52.8)111(45.9)1.0600.300
耐药[例(%)]60(83.3)186(76.9)1.3710.242
多重耐药[例(%)]34(47.2)116(47.93)0.0110.915
死亡[例(%)]15(20.8)47(19.4)0.0700.792
住院时间(d, $\bar{x}±s$)21.3±14.426.4±37.52.9610.254
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ICU患者肺部感染肺炎克雷伯菌情况分析

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项目非肺部感染组(n=72)肺部感染组(n=242)χ2/tP
女性[例(%)]20(27.8)63(26.0)0.0870.768
年龄(岁, $\bar{x}±s$)65.5±14.967.2±14.70.2610.386
医院分级[例(%)]5.9040.116
三级甲等69(95.8)207(85.5)
三级乙等06(2.5)
三级丙等1(1.4)6(2.5)
二级甲等2(2.8)23(9.5)
地区分布[例(%)]21.1230.001
华北地区14(19.4)49(20.3)
华东地区12(16.7)69(28.5)
华中地区14(19.4)58(24.0)
西南地区22(30.6)61(25.2)
华南地区4(5.6)1(0.4)
西北地区6(8.3)4(1.7)
临床有效[例(%)]52(72.2)176(71.7)0.0070.933
致病菌清除情况[例(%)]1.4330.839
未清除17(23.6)73(30.2)
清除20(27.8)60(24.8)
假定未清除3(4.3)11(4.6)
假定清除18(25.0)51(21.1)
部分清除14(19.4)47(19.4)
抗生素有效[例(%)]38(52.8)111(45.9)1.0600.300
耐药[例(%)]60(83.3)186(76.9)1.3710.242
多重耐药[例(%)]34(47.2)116(47.93)0.0110.915
死亡[例(%)]15(20.8)47(19.4)0.0700.792
住院时间(d, $\bar{x}±s$)21.3±14.426.4±37.52.9610.254
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Analysis of ICU patients with bloodstream infection with Klebsiella pneumoniae

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项目非血流感染组(n=255)血流感染组(n=59)χ2/tP
女性[例(%)]66(25.9)17(28.8)0.2120.645
年龄(岁, $\bar{x}±s$)67.3±14.464.9±15.91.1440.291
医院分级[例(%)]2.4710.481
三级甲等221(86.7)55(93.2)
三级乙等6(2.4)0
三级丙等6(2.4)1(1.7)
二级甲等22(8.6)3(5.1)
地区分布[例(%)]9.7440.083
华北地区54(21.2)9(15.3)
华东地区69(27.1)12(20.3)
华中地区57(22.4)15(25.4)
西南地区67(26.3)16(27.1)
华南地区3(1.2)2(3.4)
西北地区5(2.0)5(8.5)
临床有效[例(%)]192(75.3)36(61.0)4.9110.027
致病菌清除情况[例(%)]0.9790.913
未清除72(28.2)18(30.5)
清除63(24.7)17(28.8)
假定未清除12(4.7)2(3.4)
假定清除58(22.7)11(18.6)
部分清除50(19.6)11(18.6)
抗生素有效[例(%)]121(47.5)28(47.5)0.0001.000
耐药[例(%)]197(77.3)49(83.1)0.9490.330
多重耐药[例(%)]116(45.5)34(57.6)2.8290.093
死亡[例(%)]44(17.3)18(30.5)5.3110.021
住院时间(d, $\bar{x}±s$)26.3±36.720.9±14.62.2940.268
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ICU患者血流感染肺炎克雷伯菌情况分析

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项目非血流感染组(n=255)血流感染组(n=59)χ2/tP
女性[例(%)]66(25.9)17(28.8)0.2120.645
年龄(岁, $\bar{x}±s$)67.3±14.464.9±15.91.1440.291
医院分级[例(%)]2.4710.481
三级甲等221(86.7)55(93.2)
三级乙等6(2.4)0
三级丙等6(2.4)1(1.7)
二级甲等22(8.6)3(5.1)
地区分布[例(%)]9.7440.083
华北地区54(21.2)9(15.3)
华东地区69(27.1)12(20.3)
华中地区57(22.4)15(25.4)
西南地区67(26.3)16(27.1)
华南地区3(1.2)2(3.4)
西北地区5(2.0)5(8.5)
临床有效[例(%)]192(75.3)36(61.0)4.9110.027
致病菌清除情况[例(%)]0.9790.913
未清除72(28.2)18(30.5)
清除63(24.7)17(28.8)
假定未清除12(4.7)2(3.4)
假定清除58(22.7)11(18.6)
部分清除50(19.6)11(18.6)
抗生素有效[例(%)]121(47.5)28(47.5)0.0001.000
耐药[例(%)]197(77.3)49(83.1)0.9490.330
多重耐药[例(%)]116(45.5)34(57.6)2.8290.093
死亡[例(%)]44(17.3)18(30.5)5.3110.021
住院时间(d, $\bar{x}±s$)26.3±36.720.9±14.62.2940.268
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中国成人重症加强治疗病房肺炎克雷伯菌感染现况分析：一项全国多中心队列研究
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杨曙光 1 , 孙瑶 1 , 王婷 1 , 张华 2 , 孙薇 3 , 安友仲 1 , 赵慧颖 1, *
解放军医学杂志 | 临床研究 2025,50(3): 292-300
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解放军医学杂志 | 临床研究 2025, 50(3): 292-300
中国成人重症加强治疗病房肺炎克雷伯菌感染现况分析：一项全国多中心队列研究
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杨曙光1, 孙瑶1, 王婷1, 张华2, 孙薇3, 安友仲1, 赵慧颖1, *
作者信息
  • 1北京大学人民医院重症医学科，北京 100044
  • 2北京大学第三医院临床流行病学研究中心，北京 100191
  • 3北京大学国际医院重症医学科，北京　102206

    • 杨曙光，医学博士，主治医师，主要从事脓毒症及脓毒症休克治疗方面的研究

通讯作者:

赵慧颖，E-mail：
Clinical characteristics of Klebsiella pneumoniae in adult intensive care unit: a nationwide multi-center cohort study in China
Shu-Guang Yang1, Yao Sun1, Ting Wang1, Hua Zhang2, Wei Sun3, You-Zhong An1, Hui-Ying Zhao1, *
Affiliations
  • 1Department of Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China
  • 2Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
  • 3Department of Critical Care Medicine, Peking University International Hospital, Beijing 102206, China
出版时间: 2025-03-28 doi: 10.11855/j.issn.0577-7402.1785.2025.0226
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摘要
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目的 分析重症监护病房(ICU)住院患者肺炎克雷伯菌感染的分布、微生物学特点、耐药情况和死亡危险因素。方法 本研究为多中心前瞻性队列研究。收集2021年7月1日－2022年12月31日全国16个省(直辖市)67家有ICU科室的医院在ICU住院期间可疑感染患者的临床资料及微生物检测结果，根据患者的存活情况和耐药情况进行分组。采用单因素和多因素logistic回归分析ICU肺炎克雷伯菌感染患者的死亡危险因素和耐药危险因素。结果 共纳入2964例ICU感染患者，送检微生物标本12 175份，检出肺炎克雷伯菌487份；最终确定314例肺炎克雷伯菌感染患者，主要来源于肺部感染，耐药率为78.3%。在ICU住院期间，肺炎克雷伯菌感染患者的病死率为19.8%。单因素和多因素logistic回归分析显示，年龄大(P=0.027)、耐药率高(P=0.028)和临床有效率低(P<0.001)是ICU肺炎克雷伯菌感染患者死亡的独立危险因素。耐药分析显示，与未发生耐药者比较，发生耐药的ICU肺炎克雷伯菌感染患者的致病菌清除率(P=0.003)、临床有效率(P=0.004)、抗生素有效率(P<0.010)较低，病死率较高(P=0.006)；肺炎克雷伯菌腹腔感染(P=0.003)和尿路感染(P=0.007)者的耐药发生率较高。肺部感染肺炎克雷伯菌患者的临床有效率、肺炎克雷伯菌清除情况、耐药率、病死率及住院时间与非肺部感染肺炎克雷伯菌者比较差异无统计学意义(P>0.05)。与非血流感染者比较，血流感染肺炎克雷伯菌的患者临床有效率较低(P=0.027)、病死率较高(P=0.021)。结论 年龄大、耐药率高和临床有效率低是ICU肺炎克雷伯菌感染患者死亡的独立危险因素。血流感染肺炎克雷伯菌的ICU患者临床有效率较低、病死率较高。腹腔及尿路感染肺炎克雷伯菌的ICU患者更易发生耐药。

重症监护病房  /  感染  /  肺炎克雷伯菌

Objective To analyze the epidemiological distribution, microbiological characteristics, drug-resistance status, and risk factors for mortality in adult intensive care unit (ICU) patients with Klebsiella pneumoniae infection. Methods This multi-center prospective cohort study included ICU patients with suspected infection from 67 hospitals across 16 Chinese provinces/municipalities between July 1, 2021 and December 31, 2022. Clinical data and microbiological results were collected, and patients were divided into survival and non-survival groups according to their survival status and drug-resistance situation. Risk factors for mortality and drug resistance in ICU patients with Klebsiella pneumonia infection were determined through univariate and multivariate logistic regression analyses. Results A total of 2964 ICU-infected patients were enrolled, with 12 175 microbial specimens submitted for testing. Among these, 487 specimens tested positive for Klebsiella pneumoniae. Ultimately, 314 patients with Klebsiella pneumoniae infection were identified, primarily from lung infections, with a drug-resistance rate of 78.3%. The in-hospital mortality rate of ICU patients infected with Klebsiella pneumoniae was 19.8%. Univariate and multivariate logistic regression analyses revealed that older age (P=0.027), high drug-resistance rate (P=0.028), and low clinical-effectiveness rate (P<0.001) were independent risk factors for mortality in ICU patients infected with Klebsiella pneumoniae. Drug-resistance analysis showed that, compared with non-resistant cases, ICU patients with drug-resistant Klebsiella pneumoniae infection had lower pathogen-clearance rates (P=0.003), clinical-effectiveness rates (P=0.004), and antibiotic-effectiveness rates (P<0.010), and higher mortality rates (P=0.006). Patients with Klebsiella pneumoniae abdominal infection (P=0.003) and urinary tract infection (P=0.007) had higher drug-resistance incidences. There were no statistically significant differences in clinical-effectiveness rate, Klebsiella pneumoniae clearance, drug-resistance incidence, mortality rate, or hospital-stay length between patients with lung infection and those with non-lung infection of Klebsiella pneumoniae (P>0.05). Compared with patients with non-bloodstream infection, patients with bloodstream infection of Klebsiella pneumoniae had lower clinical-effectiveness rates (P=0.027) and higher mortality rates (P=0.021). Conclusions Older age, high drug-resistance rate, and low clinical-effectiveness rate are independent risk factors for mortality in ICU patients infected with Klebsiella pneumoniae. ICU patients with bloodstream infection of Klebsiella pneumoniae may have lower clinical-effectiveness rates and higher mortality rates. ICU patients with abdominal and urinary tract infections caused by Klebsiella pneumoniae are more likely to develop drug resistance.

intensive care unit  /  infection  /  Klebsiella pneumoniae
杨曙光, 孙瑶, 王婷, 张华, 孙薇, 安友仲, 赵慧颖. 中国成人重症加强治疗病房肺炎克雷伯菌感染现况分析：一项全国多中心队列研究. 解放军医学杂志, 2025 , 50 (3) : 292 -300 . DOI: 10.11855/j.issn.0577-7402.1785.2025.0226
Shu-Guang Yang, Yao Sun, Ting Wang, Hua Zhang, Wei Sun, You-Zhong An, Hui-Ying Zhao. Clinical characteristics of Klebsiella pneumoniae in adult intensive care unit: a nationwide multi-center cohort study in China[J]. Medical Journal of Chinese People’s Liberation Army, 2025 , 50 (3) : 292 -300 . DOI: 10.11855/j.issn.0577-7402.1785.2025.0226
正文
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肺炎克雷伯菌是一种革兰阴性、囊化、兼性厌氧细菌，在临床工作中较常见，可引起伤口、呼吸道、泌尿系感染等[1]。自20世纪80年代中期以来，高毒力肺炎克雷伯菌已成为导致严重播散性感染的重要病原体[2]。肺炎克雷伯菌已被确定为医院获得性肺炎的主要原因之一，约占所有医院获得性感染(hospital acquired infections，HAIs)的10%，在革兰阴性病原体中居第2位[3]。随着抗生素特别是碳青霉烯类抗生素的广泛、不合理使用，耐碳青霉烯类肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae，CRKP)的感染发生率有所上升[3-4]。CRKP菌株可产生多种碳青霉烯酶和(或)广谱β内酰胺酶(extended spectrum β-lactamases，ESBLs)，并伴有膜孔蛋白的丧失和外排泵的过度表达，最终导致多重耐药(multidrug resistance，MDR)、广泛耐药(extensively-drug resistant，XDR)和泛耐药(pan-drug resistant，PDR)细菌[5-7]。自从在散发病例中报告了CRKP毒株，以及随后观察到CRKP的地方性暴发，碳青霉烯耐药已在许多国家发生并成为全球性问题[3,8]。
重症监护病房(intensive care unit，ICU)因救治的危重患者病情严重、病因复杂、抵抗力低、抗生素使用较多及住院时间长，肺炎克雷伯菌感染、耐药和(或)高毒力CRKP感染的发生率和病死率明显高于其他科室[9]。一项系统综述报道，ICU患者感染CRKP的病死率为48.9%[10]。中国抗微生物药物监测网络(CHINET)报道，肺炎克雷伯菌对亚胺培南的耐药率从2005年的3.0%逐步上升至2018年的25.0%，对美罗培南的耐药率从2005年的2.9%上升至2018年的26.3%[11-12]。ICU是HAIs的主要来源，其感染风险是普通病房的3~10倍[13]。根据世界卫生组织(WHO)2010年的数据，低收入和中等收入国家中仅23个国家(15.6%)报告了有效的国家HAIs监测系统结果，因此，了解国内院内感染情况对于预防和控制院内感染极其重要。了解ICU患者感染的病原体尤其是耐药菌的分布和临床特点，可更好地预防感染、改善治疗及降低病死率。本研究通过收集全国ICU感染患者的临床资料和病原学结果，了解和分析全国ICU患者感染肺炎克雷伯菌的检出率、临床特点、病死率和耐药情况，旨在为预防和管理ICU患者肺炎克雷菌感染提供参考。
1 资料与方法
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1.1 研究对象
本研究为前瞻性队列研究，在https://clinicaltrials.gov注册(注册号为：NCT04966390)。收集2021年7月1日－2022年12月31日来自全国16个省(直辖市)的67家有ICU病房的医院在ICU住院期间可疑感染患者的临床资料。纳入标准：(1)年龄≥18岁；(2)符合ICU可疑感染的诊断。排除标准：(1)入住ICU前使用抗生素；(2)未送检微生物学检测；(3)病例资料不全。Seymour等[14]2016年在JAMA上发表的论文Assessment of Clinical Criteria for Sepsis将可疑感染定义为在使用抗生素的24 h内留取病原学检查或留取病原学检查的72 h内使用抗生素。因此，本研究将ICU可疑感染定义为入住ICU的患者使用抗生素的24 h内留取病原学检查或留取病原学检查的72 h内使用抗生素[15]。耐药菌感染定义为患者的微生物培养药敏结果中有一类或以上药物不敏感；多重耐药菌感染定义为患者的微生物培养药敏结果中三类及以上(每类中一种或更多)不敏感[16-18]。本研究获北京大学人民医院伦理委会审批(2021PHB020-001)，并通过了中国人类遗传资源采集审批(国科遗办审字[2021]CJ1420号)。
1.2 研究方法
通过电子数据采集技术网站(https://edc2.cttq.com)连续纳入ICU住院患者的临床病例资料并进行分析，包含一般病例资料[如住院号、性别、年龄、基础疾病(高血压、糖尿病、心脑血管疾病、呼吸系统疾病)史等]、临床诊断、实验室检查、影像学检查、微生物学检测结果及临床结局。微生物学检测结果由患者所在医院进行检测和鉴定，主要包括涂片、培养、病原体高通量检测。临床结局包括抗生素治疗的临床疗效、微生物学疗效、抗菌治疗的综合疗效、全因死亡率。根据患者是否存活及耐药情况进行分组，通过单因素和多因素logistic回归分析确定ICU患者感染肺炎克雷伯菌死亡和发生耐药的危险因素。
本研究中，感染肺炎克雷伯菌的ICU患者在住院过程中，只要有一次药敏结果提示为耐药菌或多重耐药菌，该患者即被归为耐药菌或多重耐药菌感染。临床有效标准定义如下。(1)符合下列标准之一视为有效：①治疗结束后感染症状、体征均得以缓解；②治疗结束后患者基线影像学检查指标改善或消失。(2)符合以下标准之一视为无效：①治疗结束时，患者症状、体征或影像学检查指标较基线时持续或恶化；②因无效而终止使用抗感染药物；③因任何原因死亡；④响应无法确定；⑤停用药物后，感染复发。
微生物学疗效根据致病菌清除情况分为以下5种：(1)清除，治疗后来自原感染部位的标本未培养出原感染的致病菌。(2)假定清除，在某些疾病，症状体征的消失使得可培养的材料无法获取(如痰液、皮肤脓液或分泌物)，或获取标本的方法对于康复的患者而言侵袭性过强，则认为微生物学结果为假定清除。为了分析的需要，清除和假定清除可合并计算清除率。(3)未清除，治疗后来自原感染部位的标本中仍然培养出原感染的致病菌。(4)假定未清除，对于被判断为临床无效的患者，在培养未做或不可能做的情况下，可假定致病菌未清除。为了最终分析的需要，上述两种未清除的分类可合并为未清除。(5)部分清除，治疗结束后，在原感染部位分离的多种致病菌中有一种及以上已被清除。
抗生素的疗效：(1)痊愈，患者在治疗结束后临床治愈，且致病菌清除或假定清除。(2)无效，患者在治疗结束后临床无效或致病菌未清除、假定未清除、部分清除，或两者兼有。如患者临床和微生物学检测结果中的某项为无效而另一项缺失，则综合疗效视为无效。
1.3 统计学处理
采用SPSS 16.0软件进行统计分析。Shapiro-Wilk检验显示计量资料均符合正态分布，以$\bar{x}±s$表示，两组间比较采用独立样本t检验；多组间比较采用重复测量方差分析，进一步两两比较采用LSD-t检验；计数资料以例(%)表示，组间比较采用χ2检验或Fisher确切概率法。将单因素分析中P<0.10的变量采用向后LR法纳入多因素logistic回归分析危险因素。P<0.05为差异有统计学意义。
2 结果
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2.1 ICU肺炎克雷伯菌感染患者的临床资料分析
共纳入了67家医院ICU中的可疑感染患者2964例，送检微生物标本共12 175份，其中涂片7074份(含痰涂片5665份、分泌物涂片1409份)，痰液标本2832份(含支气管肺泡灌洗液172份)，血液标本1218份，尿液标本315份，引流液标本263份，拭子培养473份(含皮肤拭子326份、阴道拭子63份、宫腔拭子37份和直肠拭子47份)；病原学阳性的标本有2291份。根据病原学阳性结果检测出497份克雷伯菌，其中产气克雷伯菌3份，产酸克雷伯菌7份，肺炎克雷伯菌487份。最终确定314例ICU患者感染了肺炎克雷伯菌(图1)，其中男231例，女83例；年龄21~95(66.9±14.7)岁；来自三甲医院的患者276例；西南地区ICU患者肺炎克雷伯菌的检出率最高(14.8%)，其后依次为华中地区、华东地区、西北地区、华北地区、华南地区、东北地区(表1)；死亡62例(19.8%)。ICU肺炎克雷伯菌感染患者中肺部感染242例，血流感染59例，尿路感染20例，腹腔感染14例，皮肤感染5例，颅内感染3例。发生耐药者246例(78.3%)，发生多重耐药者150例(47.8%)。
2.2 ICU肺炎克雷伯菌感染患者死亡的危险因素分析
单因素分析结果显示，与存活组比较，死亡组的地区分布差异有统计学意义(P<0.001)，且血流感染(P=0.021)、耐药(P=0.004)、多重耐药(P=0.008)的比例较高，而致病菌清除率(P<0.001)、临床有效率(P<0.001)、抗生素有效率(P<0.001)较低(表2)。对不同地区的病死率、耐药率、临床有效率和致病菌清除情况进行分析发现，西南地区病死率最高(37.3%)，华南地区的耐药率最高(100.0%)(表3)。选择单因素分析中P<0.10的变量纳入多因素logistic回归分析，结果显示，年龄大(OR=1.029，95%CI 1.003~1.055，P=0.027)、耐药率高(OR=3.454，95%CI 1.143~10.436，P=0.028)和临床有效率低(OR=0.040，95%CI 0.019~0.084，P<0.001)是ICU肺炎克雷伯菌感染患者死亡的独立危险因素。
2.3 ICU肺炎克雷伯菌感染患者的耐药情况分析
根据微生物学药敏结果将ICU肺炎克雷伯菌感染患者分为非耐药组(n=68)、耐药组(n=96)和多重耐药组(n=150)，比较3组患者的耐药情况发现，华北地区(26.0%)、华东地区(26.0%)肺炎克雷伯菌耐药病例占比最高，西南地区(35.3%)肺炎克雷伯菌多重耐药病例占比最高，差异有统计学意义(P<0.001)；与非耐药组比较，耐药组及多重耐药组致病菌清除率(P=0.003)、临床有效率(P=0.004)、抗生素有效率(P<0.010)较低，病死率较高(P=0.006)；肺炎克雷伯菌腹腔感染(P=0.003)和尿路感染(P=0.007)的耐药发生率较高(表4)。
2.4 ICU患者肺部感染肺炎克雷伯菌情况分析
在所有314例患者中有242例为肺部感染。其中华东地区肺部感染病例占比(28.5%)最高，而华南地区肺部感染病例占比(0.4%)最低，差异有统计学意义(P=0.001)；肺部感染组的临床有效率、致病菌清除情况、耐药率、病死率和住院时间等与非肺部感染组比较差异均无统计学意义(P>0.05)(表5)。
2.5 ICU患者血流感染肺炎克雷伯菌情况分析
在314例中有59例为血流感染。与非血流感染组比较，血流感染组的临床有效率较低(P=0.027)、病死率较高(P=0.021)，但致病菌未清除率(30.5%)、耐药率(83.1%)和多重耐药率(57.6%)差异无统计学意义(P>0.05)(表6)。
3 讨论
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已知肺炎克雷伯菌可引起各种感染，如血流感染、尿路感染、手术部位感染和肺炎，且易分离出耐药株[19]。本研究通过纳入67家医院的ICU可疑感染患者，在使用抗生素前或72 h内送病原学检查，共检出肺炎克雷伯菌487份，最终确定314例ICU患者感染了肺炎克雷伯菌，其中62例(19.8%)死亡。ICU患者肺炎克雷伯菌感染主要为肺部感染，其次是血流感染。肺炎克雷伯菌感染患者的耐药率较高。多因素logistic回归分析显示，年龄大、耐药和临床有效率低是ICU肺炎克雷伯菌感染患者死亡的独立危险因素。
3.1 老年患者肺部感染的特点
肺炎是老年人住院和死亡的重要原因，引起老年肺炎的病因因地区而异[20]。肺炎链球菌是西欧国家和发展中国家社区获得性肺炎的最常见病因[21]；相反，在其他东南亚国家，革兰阴性菌是老年人肺炎的常见病因，并具有较高的病死率[22]。细菌感染是老年人发生肺炎的主要原因，占61.8%，与先前亚洲国家的报告结果大体一致，如中国、日本和印度的肺炎病例中分别有49%、59%和52%与细菌感染有关[20]。日本的一项研究发现，住院老年肺炎患者感染一种以上病原菌的比例为29.3%，明显高于老年社区获得性肺炎患者感染病原菌的比例(19%)，且多重细菌感染与住院老年肺炎患者的病死率呈明显正相关[23]。耐多药和产ESBLs的微生物在老年患者肺炎的病因学中起重要作用，并与住院病死率明显相关。国内一项关于老年肺炎的研究发现，革兰阴性菌是老年人社区获得性肺炎的常见病因，其中肺炎克雷伯菌(20.4%)、铜绿假单胞菌(15.5%)和鲍曼假单胞菌(7.3%)是较常见的致病菌[21]。此外，老年人发生多重耐药感染的风险较高，普通抗生素治疗效果欠佳，因而可能导致更严重的后果。有潜在并发症的虚弱患者可能需要住ICU治疗及接受强化呼吸或血管加压支持。住院的老年肺炎患者病死率增高，在一些亚洲国家，年龄>60岁是肺炎严重程度的独立危险因素[24]。
3.2 肺炎克雷伯菌感染的特点
肺炎克雷伯菌感染是美国医院获得性肺炎的第三大病因；也是革兰阴性菌血流感染的第二大原因，仅次于大肠埃希菌[25]。肺炎克雷伯菌本身就存在部分高毒力的表型，可引起较高的病死率。肺炎克雷伯菌是人类肠道菌群的一部分，携带多种毒力基因，并具有获得多种抗生素抗性基因的能力；与经典的肺炎克雷伯菌相比，携带超黏滞表型，K1、K2、K47、K63荚膜血清表型以及magA、rmpA等遗传标记常提示肺炎克雷伯菌存在较高的毒力[2]。高毒力肺炎克雷伯菌感染有一定的侵袭性和播散性，常见于肝脓肿患者，也可引起其他部位的脓肿和感染，如脑膜炎、肺脓肿和内源性眼内炎等[26]。我国导致感染的肺炎克雷伯菌分离株中高毒力菌株的流行率较高(31.0%~37.8%)，尽管该比例在国内不同地区有所差异[27]。此外，亚洲感染高毒力肺炎克雷伯菌者14~30 d的病死率各不相同(4.5%~31.0%)[28]。抗微生物药物耐药性和毒力通常被认为是肺炎克雷伯菌致病性的重要影响因素。随着抗生素耐药性的增加，特别是耐碳青霉烯类肺炎克雷伯菌的出现，给临床治疗带来了严重的困扰。
3.3 肺炎克雷伯菌的耐药与清除
肺炎克雷伯菌是院内感染较常见的细菌之一，尤其是ICU住院患者，此外也是美国院内感染的第三大病因(9.9%)，仅次于艰难梭菌和金黄色葡萄球菌[29]。在青霉素被广泛用于治疗感染之前，细菌就出现了对β-内酰胺类抗生素的耐药性，这种耐药性是通过β-内酰胺酶水解抗生素β-内酰胺环实现的[30]。已知肺炎克雷伯菌还含有质粒介导的β-内酰胺酶(如AmpC酶)，可使其对大多数青霉素类抗生素产生耐药性[31]。ESBLs是一种基于质粒的抗性机制，是辅助基因组的一部分[32]。ESBLs能够水解氧亚胺类头孢菌素，如第三代头孢菌素和氨曲南，但可被克拉维酸抑制[33]。编码β-内酰胺酶的质粒通常也具有对其他抗生素和重金属的抗性基因，因此，ESBLs与其他辅助基因密切相关，可增强其所在菌株的适应性[34]。碳青霉烯类药物是治疗产ESBLs细菌引起的严重感染的首选药物，但在抗生素选择压力的作用下，近年来已出现碳青霉烯类耐药菌，其中肺炎克雷伯菌是最常见的碳青霉烯类耐药肠杆菌科细菌[35]。2013年，美国疾病预防控制中心宣布碳青霉烯耐药肠杆菌(carbapenem-resistant Enterobacteriaceae，CRE)是对美国公共卫生的紧急威胁，在CRE导致的约9000例感染中，约80%是由克雷伯菌引起的[36]。本研究通过对比ICU肺炎克雷伯菌感染患者中非耐药组、耐药组和多重耐药组的耐药情况发现，耐药肺炎克雷伯菌的清除率、临床疗效均较差，病死率较高，考虑可能与肺炎克雷伯菌可通过多种机制发生耐药有关。
3.4 肺炎克雷伯菌引起血流感染的特点
肠杆菌引起的血流感染可严重威胁患者的生命，病死率高达48%[37]。有研究报道，肺炎克雷伯菌引起的血流感染致死率为15%~79%，低于鲍曼不动杆菌血流感染的致死率(30%~84%)，但高于大肠埃希菌(5%~22%)[38]。一项关于中国华东地区肺炎克雷伯菌感染的回顾性研究发现，肺炎克雷伯菌引起的血流感染发病率为(4.77~9.40)/10万，耐碳青霉烯的肺炎克雷伯菌引起血流感染的菌株有197株，多重耐药肺炎克雷伯菌引起血流感染的菌株有252株，30 d病死率为26.39%[39]。本研究也发现，肺炎克雷伯菌血流感染患者的临床疗效差、病死率高，与上述研究结果一致。
综上所述，本研究通过对ICU肺炎克雷伯菌感染患者的临床资料进行分析发现，年龄大、耐药、临床有效率低和血流感染可能增高ICU肺炎克雷伯菌感染患者的病死率。腹腔和尿路感染肺炎克雷伯菌的ICU患者更易发生耐药，而肺部感染和非肺部感染肺炎克雷伯菌的ICU患者的致病菌清除情况和病死率无明显差异。但本研究仍存在一定的局限性：尽管纳入了较多地区的患者，研究对象所在医院从二级甲等到三级甲等均有分布，且在伦理审查时已确定参与本研究医院的微生物实验室符合当地或国家标准，但在实际操作和技术层面仍存在一定差异。因此，未来仍需通过更多的研究探讨ICU肺炎克雷伯菌感染患者死亡的危险因素，以进一步降低ICU感染患者的病死率，改善预后。
基金
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  • 国家自然科学基金(82202366)
文献
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参考文献 引证文献
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[1]
Arato V, Raso MM, Gasperini G, et al. Prophylaxis and treatment against Klebsiella pneumoniae: current insights on this emerging anti-microbial resistant global threat[J]. Int J Mol Sci, 2021, 22(8): 4042.
[2]
Yang X, Sun Q, Li J, et al. Molecular epidemiology of carbapenem-resistant hypervirulent Klebsiella pneumoniae in China[J]. Emerg Microbes Infect, 2022, 11(1): 841-849.
[3]
Wang M, Earley M, Chen L, et al. Clinical outcomes and bacterial characteristics of carbapenem-resistant Klebsiella pneumoniae complex among patients from different global regions (CRACKLE-2): a prospective, multicentre, cohort study[J]. Lancet Infect Dis, 2022, 22(3): 401-412.
[4]
Yang X, Dong N, Chan EW, et al. Carbapenem resistance-encoding and virulence-encoding conjugative plasmids in Klebsiella pneumoniae[J]. Trends Microbiol, 2021, 29(1): 65-83.
[5]
Spadar A, Perdigão J, Phelan J, et al. Methylation analysis of Klebsiella pneumoniae from Portuguese hospitals[J]. Sci Rep, 2021, 11(1): 6491.
[6]
Sleiman A, Awada B, Mocadie M, et al. An unequivocal superbug: PDR Klebsiella pneumoniae with an arsenal of resistance and virulence factor genes[J]. J Infect Dev Ctries, 2021, 15(3): 404-414.
[7]
Bowen T, Yingang X, Junhong L, et al. Pressure response of carbapenems Klebsiella pneumoniae under antibiotic stress[J]. Infect Genet Evol, 2021, 92: 104915.
[8]
Liu Y, Liu Y, Dai J, et al. Klebsiella pneumoniae pneumonia in patients with rheumatic autoimmune diseases: clinical characteristics, antimicrobial resistance and factors associated with extended-spectrum β-lactamase production[J]. BMC Infect Dis, 2021, 21(1): 366.
[9]
Lee YJ, Huang CH, Ilsan NA, et al. Molecular epidemiology and characterization of carbapenem-resistant Klebsiella pneumoniae isolated from urine at a teaching hospital in Taiwan[J]. Microorganisms, 2021, 9(2): 271.
[10]
Durdu B, Hakyemez IN, Bolukcu S, et al. Mortality markers in nosocomial Klebsiella pneumoniae bloodstream infection[J]. Springerplus, 2016, 5(1): 1892.
[11]
Tumbarello M, Raffaelli F, Giannella M, et al. Ceftazidime-avibactam use for Klebsiella pneumoniae carbapenemase-producing K. pneumoniae infections: a retrospective observational multicenter study[J]. Clin Infect Dis, 2021, 73(9): 1664-1676.
[12]
Lima Rodríguez O, Sousa A, Pérez-Rodríguez MT, et al. Mortality-related factors in patients with OXA-48 carbapenemase-producing Klebsiella pneumoniae bacteremia[J]. Medicine (Baltimore), 2021, 100(14): e24880.
[13]
Li D, Huang X, Rao H, et al. Klebsiella pneumoniae bacteremia mortality: a systematic review and meta-analysis[J]. Front Cell Infect Microbiol, 2023, 13: 1157010.
[14]
Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (Sepsis-3)[J]. JAMA, 2016, 315(8): 762-774.
[15]
Rhodes A, Evans LE, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016[J]. Intensive Care Med, 2017, 43(3): 304-377.
[16]
Kurt Yilmaz N, Schiffer CA. Introduction: drug resistance[J]. Chem Rev, 2021, 121(6): 3235-3237.
[17]
Shukla A, Jani N, Polra M, et al. CRISPR: the multidrug resistance endgame?[J]. Mol Biotechnol, 2021, 63(8): 676-685.
[18]
Magiorakos A P, Srinivasan A, Carey R B, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance[J]. Clin Microbiol Infect, 2012, 18(3): 268-81.
[19]
Maraolo AE, Corcione S, Grossi A, et al. The impact of carbapenem resistance on mortality in patients with Klebsiella pneumoniae bloodstream infection: an individual patient data meta-analysis of 1952 patients[J]. Infect Dis Ther, 2021, 10(1): 541-558.
[20]
Furman CD, Leinenbach A, Usher R, et al. Pneumonia in older adults[J]. Curr Opin Infect Dis, 2021, 34(2): 135-141.
[21]
Kow CS, Ramachandram DS, Hasan SS, et al. Insights into COVID-19 pneumonia among older adults: understanding aspiration and risk factors for mortality[J]. J Am Geriatr Soc, 2024, 72(8): 2613-2614.
[22]
Torres A, Cilloniz C, Niederman MS, et al. Pneumonia[J]. Nat Rev Dis Primers, 2021, 7(1): 25.
[23]
Almirall J, Serra-Prat M, Bolíbar I, et al. Risk factors for community-acquired pneumonia in adults: a systematic review of observational studies[J]. Respiration, 2017, 94(3): 299-311.
[24]
Kang Y, Fang X, Wang D, et al. Activity of daily living upon admission is an independent predictor of in-hospital mortality in older patients with community-acquired pneumonia[J]. BMC Infect Dis, 2021, 21(1): 314.
[25]
Bassetti M, Echols R, Matsunaga Y, et al. Efficacy and safety of cefiderocol or best available therapy for the treatment of serious infections caused by carbapenem-resistant Gram-negative bacteria (CREDIBLE-CR): a randomised, open-label, multicentre, pathogen-focused, descriptive, phase 3 trial[J]. Lancet Infect Dis, 2021, 21(2): 226-240.
[26]
Zhu J, Wang T, Chen L, et al. Virulence factors in hypervirulent Klebsiella pneumoniae[J]. Front Microbiol, 2021, 12: 642484.
[27]
Yang Y, Yang Y, Chen G, et al. Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in China[J]. Emerg Microbes Infect, 2021, 10(1): 700-709.
[28]
Chen J, Hu C, Wang R, et al. Shift in the dominant sequence type of carbapenem-resistant Klebsiella pneumoniae bloodstream infection from ST11 to ST15 at a medical center in NorthEast China, 2015-2020[J]. Infect Drug Resist, 2021, 14: 1855-1863.
[29]
Zhou C, Sun L, Li H, et al. Risk factors and mortality of elderly patients with hospital-acquired pneumonia of carbapenem-resistant Klebsiella pneumoniae infection[J]. Infect Drug Resist, 2023, 16: 6767-6779.
[30]
Gallegos-Miranda V, Garza-Ramos U, Bolado-Martínez E, et al. ESBL-producing Escherichia coli and Klebsiella pneumoniae from health-care institutions in Mexico[J]. J Chemother, 2021, 33(2): 122-127.
[31]
Jin X, Chen Q, Shen F, et al. Resistance evolution of hypervirulent carbapenem-resistant Klebsiella pneumoniae ST11 during treatment with tigecycline and polymyxin[J]. Emerg Microbes Infect, 2021, 10(1): 1129-1136.
[32]
Robatjazi S, Nikkhahi F, Niazadeh M, et al. Phenotypic identification and genotypic characterization of plasmid-mediated AmpC β‑lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates in Iran[J]. Curr Microbiol, 2021, 78(6): 2317-2323.
[33]
Suleiman M, Abu-Aqil G, Sharaha U, et al. Rapid detection of Klebsiella pneumoniae producing extended spectrum β lactamase enzymes by infrared microspectroscopy and machine learning algorithms[J]. Analyst, 2021, 146(4): 1421-1429.
[34]
Hernández-García M, Sánchez-López J, Martínez-García L, et al. Emergence of the new KPC-49 variant conferring an ESBL phenotype with resistance to ceftazidime-avibactam in the ST131-H30R1 Escherichia coli high-risk clone[J]. Pathogens, 2021, 10(1): 67.
[35]
Di Pilato V, Pollini S, Miriagou V, et al. Carbapenem-resistant Klebsiella pneumoniae: the role of plasmids in emergence, dissemination, and evolution of a major clinical challenge[J]. Expert Rev Anti Infect Ther, 2024, 22(1-3): 25-43.
[36]
van Duin D, Arias CA, Komarow L, et al. Molecular and clinical epidemiology of carbapenem-resistant Enterobacterales in the USA (CRACKLE-2): a prospective cohort study[J]. Lancet Infect Dis, 2020, 20(6): 731-741.
[37]
Stewart AG, Harris PNA, Chatfield MD, et al. Ceftolozane-tazobactam versus meropenem for definitive treatment of bloodstream infection due to extended-spectrum beta-lactamase (ESBL) and AmpC-producing Enterobacterales ("MERINO-3"): study protocol for a multicentre, open-label randomised non-inferiority trial[J]. Trials, 2021, 22(1): 301.
[38]
Zhou C, Jin L, Wang Q, et al. Bloodstream infections caused by carbapenem-resistant Enterobacterales: risk factors for mortality, antimicrobial therapy and treatment outcomes from a prospective multicenter study[J]. Infect Drug Resist, 2021, 14: 731-742.
[39]
Xiao S, Zhou S, Cao H, et al. Incidence, antimicrobial resistance and mortality of Klebsiella pneumoniae bacteraemia in Shanghai, China, 2018-2022[J]. Infect Dis (Lond), 2024, 56(12): 1021-1030.
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doi: 10.11855/j.issn.0577-7402.1785.2025.0226
  • 接收时间：2024-11-06
  • 首发时间：2025-11-10
  • 出版时间：2025-03-28
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  • 收稿日期：2024-11-06
  • 录用日期：2024-12-30
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National Natural Science Foundation of China(82202366)
国家自然科学基金(82202366)
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    1北京大学人民医院重症医学科，北京 100044
    2北京大学第三医院临床流行病学研究中心，北京 100191
    3北京大学国际医院重症医学科，北京　102206

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赵慧颖，E-mail：
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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