我院2005-2011年肺炎克雷伯菌的临床分布与耐药性分析  

Analysis of Clinical Distribution and Drug Resistance of Klebsiella pneumoniae in Our Hospital from 2005 to 2011

作　　者：贾秀芹[1] 陈建忠[1] 庞峰[2] 李艳华[2] 赵岐刚 

机构地区：[1]聊城市人民医院药学部,山东聊城252000 [2]聊城市人民医院检验科,山东聊城252000

出　　处：《中国药房》2013年第10期898-901,共4页China Pharmacy

摘　　要：目的:了解我院肺炎克雷伯菌的临床分布及耐药性变迁。方法:对我院2005-2011年临床分离肺炎克雷伯菌的分布特点及耐药性进行回顾性分析。结果:2776株肺炎克雷伯菌主要来源于痰(占83.9%);科室分布以脑科分院ICU为主(占28.7%),其次为呼吸内科(占12.4%)。菌株对常用抗菌药物均有不同程度耐药,对头孢唑林的耐药率较高,均大于75%;对头孢他啶、头孢曲松、头孢吡肟、氨曲南、庆大霉素和复方磺胺甲唑的耐药率波动在55.2%～84.2%之间;对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、阿米卡星、妥布霉素和左氧氟沙星的耐药率相对较低,波动在10.6%～41.3%之间。2005-2011年产ESBLs株数占年度总株数的比例分别为76.6%、88.8%、93.1%、87.2%、72.5%、69.3%、68.8%;2009-2011年出现了对碳青霉烯类抗菌药物耐药的菌株,且有逐年上升趋势,由2009年的0.2%上升到2011年的4.0%。结论:肺炎克雷伯菌耐药情况日趋严重,耐碳青霉烯类菌株的产生及播散对临床预防和治疗造成极大困难,必须引起临床高度重视。OBJECTIVE： To study the clinical distribution and the drug resistance of Klebsiella pneumoniae in our hospital. METHODS： The distribution characteristics and resistance of K. pneumoniae isolated in our hospital from 2005 to 2011 were analyzed retrospectively. RESULTS： Most of 2 776 strains of K. pneumoniae were isolated from sputum specimens （accounted for 83.9% ）; and mainly collected from ICU in cerebral branch of the hospital （accounted for 28.7% ）, the next were from department of respiratory （accounted for 12.4% ）. All strains were resistant to commonly used antibacterials more or less. From 2005 to 2011, the resistance rates to cefazolin were greater than 75%, and the resistance rate fluctuated between 55.2% to 84.2% to ceftazidime, ceftriaxone, cefepime, aztreonam, gentamicin and compound sulfamethoxazole; the resistance rate was relatively low which fluctuated between 10.6 % to 41.3 % to piperacillin/tazobactam, cefoperazone/sulbactam, amikacin, tobramycin and levofloxacin. And the proportion of strains producing ESBLs accounted for 76.6%, 88.8%, 93.1%, 87.2%, 72.5%, 69.3% and 68.8% of total number of strain, respectively. The carbapenem-resistant strains had emerged and showed an increasing trend from 2009 to 2011, rising from 0.2% in 2009 to 4.0% in 2011. CONCLUSIONS： The drug resistance of K. pneumoniae is increasingly severe. The occurrence and spread of carbapenem-resistant K. pneumoniae make great trouble for clinical prevention and treatment, on which should be focused in the clinic.

关 键 词：肺炎克雷伯菌 碳青霉烯酶 分布 耐药性 

分 类 号：R978.1[医药卫生—药品] R969.3[医药卫生—药学]