Abstract: Objective　To analyze the clinical characteristics and bacterial drug resistance in children with Klebsiella pneumoniae (KP) infection, so as to provide clinical evidences for prevention and control of KP infection. Methods　The clinical data of 68 children with sepsis of KP infection were collected from Zaozhuang Maternal and Child Health Hospital from January to December 2019 (28 males and 40 females). Antimicrobial susceptibility was tested with broth microdilution method. They were divided into an extended spectrum β-lactamases (ESBLs) positive KP infection group and an ESBLs negative KP infection group. The prognosis, length of hospital stay, grade of antibiotics used in treatment, type of antibiotics, mechanical ventilation, and so on were compared between the two groups. χ² test or Fisher exact probability method was used for the count data, and Mann-Whitney U test was used for the measurement data. Results　The mortality of the ESBLs-positive KP infection group was higher than that of the ESBLs-negative KP infection group (3/23 vs. 0/45), the length of hospital stay was longer than that of the ESBLs-negative KP infection group, the number of antibiotics used was more than that of the ESBLs-negative KP infection group, the usage rate of Carbapenms was higher than that of the ESBLs-negative KP infection group, and the mechanical ventilation rate was higher than that of the ESBLs-negative KP infection group (all P<0.05). There were no statistically significant differences in the hospitalization history and antibiotic exposure between the two groups (both P>0.05). Conclusion　The infection of KP with ESBLs positive is negatively correlated with the prognosis.

Key words: Klebsiella pneumoniae, Infection, Sepsis, Drug resistance, Clinical behaviors

摘要： 目的　分析儿童肺炎克雷伯菌（Klebsiella pneumoniae，KP）感染的临床特征及耐药性，为预防和控制耐药的KP感染提供临床依据。方法　收集枣庄市妇幼保健院2019年1月至12月经细菌培养为KP感染的68例脓毒症儿童临床资料（男28例，女40例），按照KP耐药表型分为超广谱β-内酰胺酶（extended spectrum β-lactamases，ESBLs）阳性KP感染组、ESBLs阴性KP感染组，比较两组患儿预后、住院时间、治疗中使用抗生素级别、抗生素种类、机械通气等的差别。计数资料采用χ²检验或Fisher确切概率法，计量资料采用Mann-Whitney U检验。结果　ESBLs阳性KP感染组病死率高于ESBLs阴性KP感染组（3/23比0/45），住院时间长于ESBLs阴性KP感染组，使用抗生素种类多于ESBLs阴性KP感染组，使用碳青酶烯类率高于ESBLs阴性KP感染组，机械通气率高于ESBLs阴性KP感染组（均P<0.05）；两组住院史及抗生素暴露差异均无统计学意义（均P>0.05）。结论　ESBLs阳性KP感染与预后呈负相关性。

关键词: 肺炎克雷伯菌, 感染, 脓毒症, 耐药, 临床行为