本院连续5年儿童感染肺炎克雷伯菌的分布及耐药性变化分析  

Changes of distribution and antimicrobial resistance of Klebsiella pneumonia isolated from children in 5 years in our hospital

作　　者：刘建华[1] 黄郁晶[2] 周秀珍[1] 崔兵[1] 刘勇[1] 

机构地区：[1]中国医科大学附属盛京医院检验科,沈阳110004 [2]中国医科大学附属盛京医院临床遗传科,沈阳110004

出　　处：《中国临床药理学杂志》2012年第10期749-751,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的分析儿童感染肺炎克雷伯菌的分布及耐药性变迁情况。方法用API和VITEK-2鉴定系统进行细菌鉴定,用纸片扩散法进行药敏试验,用WHONET 5.4软件分析病原菌的分离率及耐药率。结果 2006至2010年共分离到肺炎克雷伯菌329株,脓汁标本的超广谱β内酰胺酶(ESBLs)产生率显著低于其他标本(P<0.05)。连续5年肺炎克雷伯菌的ESBLs的检出率分别为46.5%,59.1%,55.6%,49.4%和45.8%,但无统计学意义(P>0.05)。肺炎克雷伯菌对青霉素类和第1,2代头孢菌素的耐药率较高,但对头孢西丁、喹诺酮类和含酶抑制剂耐药率较低,对碳青霉烯类耐药率最低。结论肺炎克雷伯菌是我院儿童细菌感染的重要致病菌,产ESBLs菌株耐药率很高,碳青霉烯类抗生素可作为其治疗的经验用药。Objective To investigate dynamic changes of distribution and antimicrobial resistance of Klebsiella pneumonia （ K. pneumoniae ） i- solated from different samples in children in our hospital. Methods Iso- lated bacteria were identified by API and VITEK -2 system, and its anti- microbial resistance was determined by Kirby - Bauer method. Data of i- solation rate and drug resistant rate were analyzed by WHONET 5.4 soft- ware. Results A total 329 K. pneumoniae isolates were collected from 2006 to 2010. The rate of extended - spectrum β - lactamase（ESBLs） - producing in strains from pus was significant lower than that of other re- sources （P 〈0. 05）. During 5 years, the detection rates of the ESBLs - producing K. pneumoniae were 46. 5% , 59. 1%, 55.6% , 49.4% and 45.8%, respectively. But no statistical difference were found （P 〉 0.05）. K. pneumoniae demonstrated much higher resistant rate to peni- cillins, and first or second generation cephalosporins, and much lower to cefoxitin, quinolones and β -lactamase inhibitors. Resistant rate to car- bapenems was lowest, and only one strain was found to be resistant to carbapenems. Conclusion pneumoniae is the main pathogen isolated from children. The ESBLs - producing strains were highly resistant to the commonly used antibiotics. Carbapenems may be used in the treatment of infections ESBLs - producing K. pneumoniae.

关 键 词：肺炎克雷伯菌 耐药性 儿童 

分 类 号：R734.2[医药卫生—肿瘤] R971.2[医药卫生—临床医学]