产ESBLs肺炎克雷伯菌的流行状况与药敏谱调查  

Prevalence and antimicrobial resistance of extended-spectrum β-lactamases producing Klebsiella pneumonia

作　　者：符永玫[1] 张永标[1] 席云[1] 张扣兴[1] 赵锋 

机构地区：[1]中山大学附属第三医院,广州510630

出　　处：《中国卫生检验杂志》2010年第2期402-403,424,共3页Chinese Journal of Health Laboratory Technology

基　　金：广东省自然科学基金资助项目(07001562)

摘　　要：目的:了解超广谱β-内酰胺酶(ESBLs)在中山大学附属第三医院临床分离肺炎克雷伯菌中的流行状况与产酶菌株的药敏谱特征。方法:采用K-B纸片法进行药敏试验和ESBLs的表型筛选与确证试验,应用WHONET5.4软件进行数据统计分析。结果:2008年7月至2009年6月临床分离的107株无重复肺炎克雷伯菌中ESBLs的检出率为43.0%(46/107)。产ESBLs菌株呈多重耐药表型,对亚胺培南的敏感率为100.0%,对大多数抗菌药物的敏感率明显低于非产酶菌株(P<0.05)。结论:ESBLs在肺炎克雷伯菌中广为流行,临床上宜严格限制广谱β-内酰胺类抗菌药物的应用,以减少ESBLs的产生与流行;产ESBLs细菌轻症感染应根据药敏结果选择抗菌药物,重症感染则首选亚胺培南。Objective：To investigate the prevalence and antimicrobial resistance of extended-spectrum β-lactamases（ESBLs） producing Klebsiella pneumonia（K.pneumonia） in our hospital.Methods：Antimicrobial susceptibility tests,screening and confirmatory tests for ESBLs were done by Kirby-Bauer disk diffusions method,WHONET 5.4 software was used for data statistic analysis.Results：ESBLs producing strains were detected in 43.0% of 107 clinical isolates of nonrepetitive K.pneumonia between July 2008 and June 2009.Multidrug resistant phenotypes were found in ESBLs producing strains.The susceptibility rate of ESBLs producing strains to imipenem was 100.0%,while to most antimicrobial agents were lower than that of non-ESBLs producing strains（P〈0.05）.Conclusion：ESBLs are popular in K.pneumonia,and the use of broad-spectrum β-lactams should be restricted,so as to reduce emersion and prevalence of ESBLs producing strains in clinc.The antimicrobial agents for treating mild infections caused by ESBLs producing K.pneumonia should be chosen according to the results of the antimicrobial susceptibility tests,but imipenem is the first choice for severe infections.

关 键 词：超广谱Β-内酰胺酶 肺炎克雷伯菌 耐药性 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]