肺炎克雷伯菌428株临床分布及耐药性分析  

Analysis of drug resistance and clinical distribution of 428 strains of Klebsiella pneumonia

作　　者：姚辉[1] 何祖祥[1] 

机构地区：[1]邵阳医学高等专科学校附属医院检验科,湖南邵阳422000

出　　处：《现代医药卫生》2014年第17期2598-2599,2614,共3页Journal of Modern Medicine & Health

摘　　要：目的探讨肺炎克雷伯菌的临床分布及对抗菌药物的耐药情况,为临床合理选用抗菌药物提供参考。方法收集2008年1月至2011年12月该院住院患者各类标本中分离的肺炎克雷伯菌428株,对其临床分布及药敏试验结果进行回顾性分析。结果 428株肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)菌183株(42.76%)。药敏试验结果显示,产ESBLs肺炎克雷伯菌对亚胺培南、阿米卡星、哌拉西林/他唑巴坦耐药率较低,分别为0.00%(0/183)、12.02%(22/183)和18.03%(33/183);对头孢菌素类和单环β-酰胺类抗菌药物呈现高度耐药性;对氨基糖苷类、氟喹诺酮类、磺胺类抗菌药也存在较高耐药性,其中喹诺酮类的耐药率变化最为显著。结论肺炎克雷伯菌耐药现象严重,特别是产ESBLs肺炎克雷伯菌,临床医生应根据药敏试验结果并结合临床感染情况合理使用抗菌药物,有效控制耐药菌的产生,避免耐药菌株的传播。Objective To investigate the clinical distribution and drug resistance to antibacterials of Klebsiella pneumo-niae,in order to provide clinical reference for rational use of antibacterial agents. Methods A total of 428 strains of Klebsiella pneumonia,which were isolated from inpatients from January 2008 to December 2011 in the hospital,were collected and analyzed retrospectively on clinical distribution and results of drug susceptibility test. Results In 428 strains,183 strains were extended-spectrum-beta-1actamases （ESBLs）-producing Klebsiella pneumoniae （42.76%）. Drug susceptibility test results showed that the drug resistance rates of ESBLs-producing Klebsiella pneumonia to imipenem,amikacin,piperacillin/tazobactam were 0.00%（0/183）, 12.02%（22/183） and 18.03%（33/183） respectively;it had high drug-resistance to cephalosporins and monocyclicβ-lactam an-tibacterial agents;and the drug resistance to aminoglycoside,fluoroquinolone,sulfonamide was relatively high,especially the re-sistance rate changes of quinolones was the most significant. Conclusion The drug resistance of Klebsiella pneumonia is seri-ous,especially the ESBLs-producing Klebsiella pneumonia,so the clinicians should make rational use of antibacterial agents based on susceptibility test results,combining with clinical infection,to control the generation of drug-resistance bacteria effec-tively and avoid the dissemination of drug-resistant strains.

关 键 词：克雷伯菌 肺炎 抗菌药 药物耐受性 Β内酰胺酶类 

分 类 号：R978.11[医药卫生—药品]