老年患者医院感染产ESBLs及AmpC酶肺炎克雷伯菌检测及耐药性分析  

Detection of ESBLs-and AmpC-producing Klebsiella pneumoniaecausing nosocomial infections in eldely hospitalized patients and analysis of drug resistance

作　　者：郑素君[1] 

机构地区：[1]台州市第一人民医院泌尿科,浙江台州318020

出　　处：《中华医院感染学杂志》2013年第6期1450-1452,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解老年住院患者在医院感染肺炎克雷伯菌产ESBLs及AmpC酶的情况,为临床用药提供参考。方法对2011年高龄住院患者进行病例剖析,整理出各类标本中分离的肺炎克雷伯菌单产ESBLs、AmpC酶和同产ESBLs及AmpC酶菌株的检出率及耐药性。结果从老年住院患者各类标本中共分离到肺炎克雷伯菌97株,单产ESBLs 29株,占29.9%,单产AmpC酶16株,占16.5%,同产ESBLs及AmpC酶8株,占8.3%;产酶与非产酶菌株除对亚胺培南敏感率100.0%外,对其余β-内酰胺类抗菌药物头孢菌素类呈高度耐药,产酶菌株耐药率高于非产酶菌株,同产ESBLs及AmpC酶菌株耐药率要高于单产ESBLs和AmpC酶菌株。结论老年住院患者感染的肺炎克雷伯菌单产ESBLs、AmpC酶及同产ESBLs及AmpC酶菌株检出率较高,并且产酶菌株对多种抗菌药物呈耐药状态。OBJECTIVE To understand the status of ESBLs- and AmpC producing Klebsiella pneumoniae causing nosocomial infections in the elderly hospitalized patients so as to guide the clinical medication. METHODS The case-control study was conducted for the elderly hospitalized patients in 2011, and the ESBLs- and AmpC- producing K. pneumoniae isolated from various clinical specimens were collected,then the detection rate and the drug resistance were analyzed. RESULTS There were totally 97 strains of K. pneumoniae isolated from various specimens obtained from the elderly hospitalized patients,among which there were 29 （29.9%） strains of ESBLs- producing isolates and 16 （16. 5%） strains of AmpC-producing isolates, and there were 8 （8. 3%）strains of ESBLs- and AmpC-producing isolates. The drug susceptibility testing result indicated that the enzyme-producing and non-anzyme producing strains were 100% sensitive to imipenem and were highly resistant to the rest of the beta-lactam antibacterials cephalosporins, the drug resistance rate of the enzyme-producing strains was higher than that of the non-enzyme-producing strains,and the drug resistance rate of the ESBLs- and AmpC producing stains was higher than that of the ESBLs-producing or AmpC-producing strains. CONCLUSION The detection rates of the ESBLs-producing K. pneumoniae and the AmpC-producing K. pneumoniae as well as the ESBLs-and AmpC- producing strains are high,and the enzyme-producing strains are multidrug-resistant.

关 键 词：肺炎克雷伯菌 老年住院患者 AMPC酶 

分 类 号：R378.996[医药卫生—病原生物学]