荆州市医院感染肺炎克雷伯菌的现状及耐药性分析  

Current status of Klebsiella pneumoniaeinfections in Jinzhou and analysis of drug resistance

作　　者：柳文菊[1] 刘学政[1] 汪功文[1] 周莉[1] 谢良才[1] 陈铭[2] 

机构地区：[1]长江大学附属第一医院检验科,湖北荆州434000 [2]长江大学附属第一医院中心实验室,湖北荆州434000

出　　处：《中华医院感染学杂志》2012年第16期3655-3657,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解荆州市医院肺炎克雷伯菌的感染现状及耐药性,为临床医师合理用药提供科学依据。方法对2008年1月-2010年12月荆州市10所综合性医院4528株肺炎克雷伯菌(KPN)的鉴定严格按照《全国临床检验操作规程》进行,采用法国生物梅里埃公司VITEK-32全自动微生物分析仪操作;药敏试验采用CLSI推荐的K-B法;产超广谱β-内酰胺酶(ESBLs)菌株检测采用双纸片协同法和纸片确证试验。结果 4528株KPN主要分离自ICU、呼吸内科、神经外科、肝胆外科及冠心病监护病房,分别占34.9%、11.1%、8.3%、8.1%及7.2%;感染标本主要为痰液、咽拭子、尿液和分泌物;KPN产ESBLs检出率为36.0%;KPN对氨苄西林的耐药率最高,达97.6%;对头孢哌酮/舒巴坦、阿米卡星、哌拉西林/他唑巴坦、头孢西丁耐药率较低,为17.8%～22.4%;未检出对亚胺培南和美罗培南耐药的KPN。结论 KPN耐药性已十分严重,卫生行管部门及各医院应制定有效的监管措施,积极控制耐药菌株的播散并预防医院感染。OBJECTIVE To analyze the drug resistance of clinically isolated Klebsiella pneumoniae （KPN） and the infection status so as to provide the evidence for clinical reasonable use of antibiotics. METHODS The identification of 4528 strains of KPN isolated from ten general hospitals in Jingzhou from Jan 2008 to Dec 2010 was performed by VITEK-32 automatic microbiological analyzer system of BioMerieux, France; the drug susceptibility testing was carried out by K-B method recommended by CLSI; the detection of ESBLs-producing strains was performed by means of double-disk synergy and disk phenotypic confirmatory test. RESULTS A total of 4528 strains of KPN were mainly isolated from the ICU, department of respiratory medicine, department of neurosurgery, department of hepatobiliary surgery, and coronary care unit, accounting for 34. 9%, 11. 1%, 8. 3%, 8. 1%, and 7. 2%, respectively; the main specimens infected with KPN were the sputum, throat swabs, urine, and secretions the detection rate of the ESBLs-producing KPN was 36. 0%; the drug resistance rate of KPN was the highest to ampicillin, reaching up to 97. 6% the antibiotic resistance rates to cefoperazone/sulbactam, amikacin, piperacillin/tazbactam were relatively low, varying from 17.8% to 22.4% no strain resistant to imipenem and meropenem was detected. CONCLUSION The drug resistance of KPN has been so serious that the health care administrative departments and the hospital should develop effective supervision measures so as to control the resistant strains and prevent nosocomial infections.

关 键 词：医院感染 肺炎克雷伯菌 耐药性 荆州市 

分 类 号：R378.996[医药卫生—病原生物学]