小儿下呼吸道肺炎克雷伯菌感染及耐药性分析  

Investigation on detection rate and antibiotic resistance of lower respiratory tract infection caused by Klebsiella pneumoniae in children

作　　者：林伟青[1] 林佩贤[1] 辜红妮[1] 陈晓东[1] 李伟中[1] 

机构地区：[1]汕头大学医学院第二附属医院,广东汕头515041

出　　处：《中华医院感染学杂志》2014年第23期5769-5771,共3页Chinese Journal of Nosocomiology

基　　金：广东省科技厅社会发展计划基金资助项目(2012B031800216)

摘　　要：目的了解小儿下呼吸道肺炎克雷伯菌的感染及耐药性,为指导临床抗菌药物治疗提供依据。方法对2012年1-12月儿科住院患儿送检的827份痰标本中分离培养出的肺炎克雷伯菌及其耐药性进行调查分析,采用SPSS17.0软件进行统计分析。结果共检出肺炎克雷伯菌76株,检出率为9.19%;肺炎克雷伯菌对头孢唑林、磺胺甲噁唑/甲氧苄啶和呋喃妥因耐药率较高,分别为64.45%、61.84%和80.26%,对阿米卡星、亚胺培南、厄他培南、头孢替坦、哌拉西林/他唑巴坦的耐药率较低,分别为0、1.32%、1.32%、3.95%、2.63%;产ESBLs菌株对多种抗菌药物的耐药率高于非产ESBLs菌株。结论肺炎克雷伯菌是引起小儿下呼吸道感染的常见细菌,其产ESBLs菌株对多种抗菌药物呈现耐药,引起的疾病负担较重;应根据监测结果合理选择抗菌药物,控制耐药菌株产生,以有效治疗该菌引起的下呼吸道感染性疾病。OBJECTIVE To investigate lower respiratory tract infection caused by K lebsiella pneumoniae in chil‐dren ,and study the antimicrobial resistance of pathogens so as to provide reference for clinical antibacterial treat‐ment .METHODS Sputum specimens for bacterial culture were collected from children with lower respiratory tract infection in Jan .to Dec .2012 to analyze K .pneumoniae and its drug resistance .The software SPSS17 .0 was used for statistical analysis .RESULTS A total of 76 strains of K . pneumoniae were detected （the detection rate 9 .19% ） .The drug susceptibility results showed drug resistance rates of strains were fairly high to cefazolin , SMZ‐TMP and macrodantin ,and the rates were low to amikacin ,imipenem ,ertapenem ,cefotetan and piperacil‐lin/tazobactam ,being 0 ,1 .32% ,1 .32% ,3 .95% ,and 2 .63% respectively .The resistance rates of ESBLs‐pro‐ducing strains to antibacterial drugs were significantly higher than those of non‐ESBLs‐producing strains . CONCLUSION K lebsiella pneumoniae was the common pathogen causing lower respiratory tract infection in chil‐dren .ESBLs‐producing strains showed multi‐drug resistance and resulted in heavier burden of diseases .The trend of antimicrobial resistance should be considered for selecting antibiotics rationally in order to decrease the occur‐rence of drug resistant strains and treat lower respiratory tract infection effectively .

关 键 词：小儿 下呼吸道感染 肺炎克雷伯菌 耐药 

分 类 号：R378.996[医药卫生—病原生物学]