肺炎克雷伯菌感染部位分布及耐药性分析  

Distribution and drug resistance of clinical isolates of Klebsiella pneumoniae

作　　者：陈刚[1] 陈荣[1] 邓子德[2] 叶丽艳[1] 杨继勇[1] 罗燕萍[1] 

机构地区：[1]解放军总医院微生物科,北京100853 [2]中山大学附属第三医院医院感染管理科,广东广州510630

出　　处：《中华医院感染学杂志》2013年第22期5562-5563,5566,共3页Chinese Journal of Nosocomiology

基　　金：军队后勤科研"十二五"基金资助(AWS11C001)

摘　　要：目的了解医院分离肺炎克雷伯菌的分布及其耐药性,为临床合理用药提供参考。方法药敏试验采用纸片扩散法,数据分析采用WHONET5.6进行分析。结果肺炎克雷伯菌主要来源于痰液和尿液,分别占48.1%和14.5%;480株肺炎克雷伯菌共检出产ESBLs菌株179株,阳性率37.3%,其对哌拉西林、氨苄西林/舒巴坦、头孢他啶、头孢噻肟、环丙沙星和磺胺甲噁唑/甲氧苄啶的耐药率分别为97.8%、70.4%、51.4%、97.2%、52.0%、76.5%,非产ESBLs菌株对常用抗菌药物耐药率均<24.6%。结论产ESBLs肺炎克雷伯菌比非产ESBLs菌株具有更高的耐药率,药物治疗可以选择亚胺培南、美罗培南、阿莫西林/克拉维酸、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢吡肟和阿米卡星。OBJECTIVE To investigate the distribution and drug resistance of clinical isolates of Klebsiella pneurnoniae so as to guide the reasonable clinical use of antibiotics. METHODS The drug susceptibility testing was performed by disk diffusion method, and the data were analyzed with the use of WHONET5.6 software. RESULTS Of totally the K. pneumoniae strains isolated, 48.1% were from the sputum, 14.5% from the urine; a total of 179 strains of ESBLs-producing K. pneumoniae laave been detected among 480 strains of K. pneurnoniae with the positive rate of 37. 3%. The drug resistance rate of the ESBLs-producing K. pneumoniae to piperacillin was 97.8%, ampicillin-sulbactam 70. 4%, ceftazidime 51. 4%, cefotaxime 97. 2%, ciprofloxacin 52. 0%, and sulfamethoxazole-trimethoprim 76. 5 % ; the drug resistance rate of the non-ESBLs-producing strains to the commonly used antibiotics was less than 24.6 %. CONCLUSION The drug resistance rate of the ESBLs-producing Klebsiella pneumoniae is significantly higher than that of the non-ESBLs-producing strains; the meropenem, imipenem, amoxicillin-clavulanic acid, cefoperazone-sulbactam, piperacillin-tazobactam, cefepime, and amikacin are recommended for the drug therapy.

关 键 词：肺炎克雷伯菌 抗菌药物 耐药 

分 类 号：R378.996[医药卫生—病原生物学]