新生儿感染性疾病肺炎克雷伯菌的阳性率及药敏分析  

Positive rate and susceptibility test of Klebsiella pneumoniae in newborn infants with infectious disease

作　　者：孙佰秀[1] 荆相瑜 

机构地区：[1]山东省青岛市妇女儿童医疗保健中心检验科,青岛266011

出　　处：《中国实用儿科杂志》2011年第9期699-701,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的测定肺炎克雷伯菌在感染性疾病的新生儿痰、血及脑脊液标本的阳性率及耐药率。方法收集山东省青岛市妇女儿童医疗保健中心2008年1月至2010年6月新生儿科感染性肺炎563例、败血症553例及化脓性脑膜炎29例病例标本,用自动微生物鉴定及药敏分析系统(ATB系统)进行鉴定并行药敏试验。结果肺炎克雷伯菌阳性率分别为痰40.3%、血22.1%,明显高于其他优势菌;脑脊液为22.2%,与其他优势菌相比无明显差异。对碳烯类、阿米卡星、奈替米星耐药率为零;对环丙沙星、哌拉西林+三唑巴坦、头孢西丁、妥布霉素耐药率均小于10%;对头孢噻吩、头孢噻肟、头孢他啶、头孢吡肟、阿莫西林、哌拉西林、替卡西林耐药率均高于80%。超广谱β内酰胺酶(ESBLs)检出情况分别为痰75.2%、血84.0%,脑脊液2例均为ESBLs。结论肺炎克雷伯菌已成新生儿感染优势菌,ESBLs菌株呈上升趋势。肺炎克雷伯菌对碳烯类、氨基糖苷类、喹诺酮类及酶抑制剂耐药率低。Objective To determine the positive rate and drug resistance rate of Klebsiella pneumoniae in sputum, bloodand cerebrospinal fluid specimens. Methods Samples of transmissibility pneumonia, sepsis and purulent meningitis in neonatal period were collected from January 2008 to June 2010 in Qingdao Women and Children＇s Medical Center. Identity and susceptibility test were detected by ATB system. Results The positive rate of Klebsiella pneumoniae in sputum and blood were 40.3% and 22.1% respectively, which were significantly higher than the other dominant bacteria. It was 22.2% in cerebrospinal fluid. Compared with other dominant bacteria, there was no significant difference. Klebsiella pneumoniae was sensitive to carbon vinyl meropenem, imipenem, amikacin and netilmicin, and its drug fast rate was zero. The drug fast rate of ciprofloxacin, piperacillin ＋ tazobactam, cefoxitin and tobramycin was less than 10%. However, it was hardly sensitive to Cefalotin, cefotaxime, ceftazidime, cefepime, amoxicillin, piperacillin and ticarcillin. The drug fast was all more than 80%. The percent age of ESBLs cases in sputum and blood was 75.2% and 84.0%. Two cerebrospinal fluid samples were both ESBLs. Conclusion Klebsiella pneumoniae has been the predominant bacteria in neonatal infection, and ESBLs strains are rising. Klebsiella pneumoniae is sensitive to carbonalkenes, aminoglycosides and quinolones.

关 键 词：新生儿 肺炎克雷伯菌 阳性率 药敏试验 

分 类 号：R72[医药卫生—儿科]