产ESBLs肺炎克雷伯菌临床分布特征及耐药性分析  

Clinical distribution and drug resistance of ESBLs-producing Klebsiella pneumoniae

作　　者：王玉红[1] 邓敏[2] 闵晓春[3] 

机构地区：[1]武汉市普爱医院西院感染管理科,湖北武汉430034 [2]华中科技大学附属协和医院医院感染管理科,湖北武汉430022 [3]武汉市普爱医院检验科,湖北武汉430034

出　　处：《中华医院感染学杂志》2014年第21期5213-5214,5217,共3页Chinese Journal of Nosocomiology

基　　金：湖北省科技攻关基金资助项目(AA301C41)

摘　　要：目的：分析产ESBLs肺炎克雷伯菌的分布特征及耐药性，以指导临床合理用药。方法收集医院2013年1-12月门诊和住院患者分离所得的105株肺炎克雷伯菌，采用A Pl系统进行细菌鉴定，药敏试验采用琼脂扩散法，结果判定按NCCLS标准执行，数据统计按世界卫生组织细菌耐药性监测组软件 WHONET4系统处理。结果105株肺炎克雷伯菌检出产ESBLs菌株50株，检出率47．6％；标本来源以患者的痰液、尿液、伤口分泌物为主，检出率分别为52．1％、50．0％、33．3％，科室分布以老年病房最多，检出率为48．0％；产ESBLs肺炎克雷伯菌对碳青霉烯类抗菌药物高度敏感，达100．0％，对青霉素类敏感率很低为0～8．0％。结论产ESBLs肺炎克雷伯菌对临床常用抗菌药物的耐药率较高，所以合理选用抗菌药物很重要，应加强细菌培养及药物敏感试验，以指导临床用药。OBJECTIVE To observe the distribution and drug resistance of ESBLs-producing K lebsiella pneumoniae so as to provide guidance for the reasonable clinical use of antibiotics .METHODS From Jan 2013 to Dec 2013 ,a to-tal of 105 strains of K .pneumoniae were isolated from the outpatients and the hospitalized patients ,the bacterial i-dentification was carried out by using APl system ,the drug susceptibility testing was performed with the use of agar dilution method ,the results were interpreted according to the NccLs ,and the data were statistically analyzed by using the WHONET4 software .RESULTS Among the 105 strains of K .pneumoniae ,50 strains of ESBLs-pro-ducing K .pneumoniae were detected with the detection rate of 47 .6% .The sputum ,urine ,and wound secretions were the predominant specimens sources ,52 .1% of the ESBLs-producing strains were isolated from the sputum specimens ,50 .0% from the urine specimens ,33 .3% from the wound secretions ;48 .0% of the ESBLs-producing strains distributed in the geriatric ward .The ESBLs-producing K .pneumoniae strains were highly susceptible to the carbapenems ,with the drug susceptibility rate of 100 .0% ,and the drug susceptibility rate to penicillin varied from 0 to 8 .0% .CONCLUSION The isolates of ESBLs-producing K .pneumoniae are highly resistant to the com-monly used antibiotics ,it is crucial to reasonably use antibiotics ;the bacterial culture and the drug susceptibility testing should be strengthened so as to guide the clinical use of antibiotics .

关 键 词：肺炎克雷伯菌 产超广谱Β-内酰胺酶 分布特征 耐药性 

分 类 号：R378.996[医药卫生—病原生物学]