肺炎克雷伯菌院内感染特点及其耐药性分析  

Characteristics of Nosocomial Infection of Klebsiella Pneumonia and Its Drug Resistance

作　　者：王伟[1] 林翀[2] 李珑[1] 王根妹 林碧玲[1] 

机构地区：[1]海南省农垦总局医院护理部,海南海口570311 [2]海南省农垦总局医院东湖院区检验科,海南海口570311

出　　处：《现代生物医学进展》2008年第12期2305-2307,共3页Progress in Modern Biomedicine

摘　　要：目的:探讨肺炎克雷伯菌院内感染分布特点和耐药情况,并指导临床合理选择抗菌药物。方法:对128例肺炎克雷伯菌感染者的临床资料及药敏试验结果进行分析。结果:肺炎克雷伯菌院内感染者平均年龄68.5岁,其中>60岁92例(71.9%);临床送检标本中痰液(54.69%)、尿液(24.22%)、血液(9.38%)标本分离菌株数多,发生肺炎克雷伯菌感染的科室主要分布于ICU(28.91 %)、呼吸消化科(19.53%)、血液内分泌科(14.06%)、干部病房(11.72%);产超广谱β-内酰胺酶(ESBLs)菌株40.62%;除亚胺培南和美罗培南外,所有受试菌株对其余抗菌药物均有不同程度的耐药,产ESBLs菌株对所测试的抗菌药物耐药率明显高于非产ESBLs株;49.72%的产ESBLs菌株呈多重耐药性。结论:初步了解了肺炎克雷伯菌院内感染特点,其耐药现象较严重,ESBLs检出率较高,多重耐药现象突出。临床应重视监测肺炎克雷伯菌流行情况,合理使用抗菌药物。Objective： To investigate the characteristics of nosocomial infection of Klebsiella pneumonia and its drug resistance, and to provide scientific evidence for clinical reasonable usage of antibiotics. Methods： Clinical data and its infection characteristics and drug resistance of 128 patients with Klebsiella pneumonia were analyzed. Results： One hundred and twenty-eight strains ofK. pneumoniae were isolated mostly from sputum （54.69 %）,urine （24.22 %）,blood （9.38 %.Infection caused by K. pneumoniae were frequently occurred in intensive care units （ICU, 28.91%）, departments of respiratory and gastroenterology （19.53 %）, departments of hematology and endocrinology （14.06 %）, and cadre wards （11.72 %）. The isolated rate ofK. pneumoniae producing Extended-Spectrum β-Lactamases （ESBLs） was 40.62%.Except for imipenem and Meropenem, the 128 strains bacteria were susceptible to the other 13 tested anti-bacterial agents to a certain extent. There were isolates producing ESBLs,which showed much higher resistance to the tested antimicrobial agents than non-ESBLs-producing K. pneumoniae.Multi-drug resistance appeared in 49.72 % of strains producing ESBLs. Conclusion： This article described the characteristics of nosocomial infections of K. pneumoniae preliminarily, showing severe drug resistance of K. pneumoniae. The detection rate for K. pneumoniae producing ESBLs was high, with multi-drug resistance. The prevalence of nosocomial infections ofK. pneumoniae should be supervised, and the antimicrobial agents should be used reasonably.

关 键 词：肺炎克雷伯菌 抗菌药物 耐药性 院内感染 

分 类 号：R378[医药卫生—病原生物学]