克雷伯菌属的耐药性分析  

Resistance Analysis of Klebsiella

作　　者：赵建平[1] 曹银芳[1] 宿俊彪[1] 冯笑梅[1] 

机构地区：[1]内蒙古自治区医院,内蒙古呼和浩特010017

出　　处：《中华医院感染学杂志》2005年第1期106-107,共2页Chinese Journal of Nosocomiology

基　　金：内蒙古自治区科学技术攻关资助项目(990122;20000211)

摘　　要：目的通过147株,其中15株产超广谱β内酰胺酶(ESBLs)和132株非产超广谱β内酰胺酶株克雷伯菌属对22种抗菌药物的耐药性分析,指导临床合理用药。方法细菌鉴定采用API系统和手工法,药敏试验和产ESBLs细菌的检测采用KB法,结果判定按NCCLS标准执行,数据统计采用上海金仕达软件。结果克雷伯菌属的检出以咽拭子和痰标本为主;产ESBLS克雷伯菌属检出率为10.2%;产ESBLs克雷伯菌属对亚胺培南、头孢哌酮/舒巴坦耐药性最低(0～1.5%),对阿米卡星有一定的作用(耐药率40.0%);非产ESBLs克雷伯菌属对亚胺培南、头孢哌酮/舒巴坦、三代头孢、氨基糖苷类、喹诺酮类、呋喃妥因具有良好的作用(耐药率6.8%～25.0%);产ESBLs克雷伯菌属的耐药性明显高于非产ESBLs菌株(P<0.001)。结论临床应根据体外药敏试验及产ESBLS细菌检测的结果,合理选择抗菌药物。OBJECTIVE To analyze the drug resistance of 147 Klebsiella (15 ESBLs and 132 non-ESBLs) strains against 22 antibiotics, in order to help the clinic to choose drug rationally. METHODS The bacteria assay ~adopted API system and manual method, the drug resistance and the test of ESBLs Klebsiella were taken by ~K-B method, according NCCLS and using Shanghai Jinshida software for data statistics. RESULTS Klebsiella were isolated from pharynx and sputum. The test rate of ESBLs Klebsiella was 10.2%, they had low resistance ~against imipenem and cefoperazone/sulbactam, but had certain resistance against amikacin (40%). The ~non-ESBLs Klebsiella had good activity to imipenem, cefoperazone/sulbactam, third generation cephalosporins, aminoglycosides, quinolones and nitrofurantoin, the rate of resistance was from 6.8% to ~25.9%. The drug ~resistance of ESBLs Klebsiella was more higher than the non-ESBLs ones (P<0.001). ~CONCLUSIONS The clinic should choose antibiotic rationally according the in vitro antimicrobial agents susceptibility and the ESBLs test.

关 键 词：克雷伯菌 超广谱Β-内酰胺酶 耐药性 

分 类 号：R378.99[医药卫生—病原生物学]