小儿肺炎克雷伯菌临床感染及耐药性分析  

Clinical infection and drug resistance analysis of Klebsiella pneumoniae in children pneumonia

作　　者：刘佳强[1] 顾敏[1] 金今[1] 周喜桃[1] 陈冰玉[1] 

机构地区：[1]湖南省株洲市一医院检验科,412000

出　　处：《检验医学与临床》2011年第18期2203-2204,共2页Laboratory Medicine and Clinic

摘　　要：目的分析住院患儿肺炎克雷伯菌的临床分布及耐药性,以指导临床合理用药。方法对2009年10月至2010年12月儿科送检标本分离出的肺炎克雷伯菌的临床分布特点及耐药情况进行总结分析。结果共分离出肺炎克雷伯菌172株,其中产超广谱β-内酰胺酶(ESBLs)菌41株,占23.84%;主要来源于咽拭子、血液和痰液等,分别占70.93%、9.88%和8.14%;肺炎克雷伯菌对亚胺培南、厄它培南、丁氨卡那霉素和哌拉西林/他唑巴坦敏感性高。结论小儿肺炎克雷伯菌主要引起下呼吸道感染;对氨苄西林、氨苄西林/舒巴坦及头孢类抗菌药物耐药率高,哌拉西林/他唑巴坦和亚胺培南可作为治疗儿童产ESBLs肺炎克雷伯菌感染或非产ESBLs菌严重感染的首选用药。Objective To investigate the clinical distribution and antimicrobial resistance of Klebsiella pneumoniae in children infections for guiding the reasonable application of antibiotics. Methods The drug resistance situation and distribution characteristics of K. pneumoniae isolated from our hospital in the last year were summarized and analyzed retrospectively. Results Total 172 strains of K. pneumoniae were isolated during this period. Among them, there were 41 extended spectrum β lactamase（ESBLs）-producing strains, accounting for 23.84%. The main resourses were secretions,blood and sputum, accounting for 70. 93%, 9. 88% and 8. 14%, respectively. The isolated strains were more sensitive to imipenem, amikacin and piperacillin/tazobactam. Conclusion K. pneumoniae mainly causes lower respiratory tract infections in children. K. pneumoniae is severely resistance to ampicillin,ampicillin/sulbactam and cephalosporin. Imipenem and piperacillin/tazobactam remain to be the first choice to treat the severe infection caused by K. pneumoniae in children.

关 键 词：克雷伯菌 肺炎 细菌感染 儿童 Β内酰胺酶类 药物耐受性 微生物敏感性试验 

分 类 号：R631[医药卫生—外科学]