产超广谱β-内酰胺酶肺炎克雷伯菌的耐药性分析  

Drug resistance analysis of extended-spectrum β-lactamase-producing Klebsiella pneumoniae

作　　者：王亚华[1] 祝永明[2] 邵平扬[3] 陈松劲[3] 吴晓燕[3] 宋秀兰[4] 冯雪君[3] 

机构地区：[1]浙江省嘉兴市第一医院药剂科,浙江嘉兴314001 [2]浙江省嘉兴市第二医院药剂科,浙江嘉兴314000 [3]浙江省嘉兴市第二医院检验科,浙江嘉兴314000 [4]浙江省嘉兴市第一医院检验科,浙江嘉兴314001

出　　处：《中国医药导报》2014年第36期70-74,共5页China Medical Herald

基　　金：浙江省重点科技创新团队建设项目(编号2010R50019)

摘　　要：目的 调查分析临床产超广谱β-内酰胺酶（ESBLs）肺炎克雷伯菌的耐药性,为临床合理使用抗菌药物和及早预防和控制医院感染提供科学依据。方法 回顾性统计2012年1月~2013年12月嘉兴地区两所综合性三甲医院中分离的产ESBLs肺炎克雷伯菌的临床资料,进行耐药性分析。结果 2012年1月~2013年12月间共检出肺炎克雷伯菌4145株,其中产ESBLs菌株855株,且2012、2013年阳性检出率分别为19.95%（387/1940）、21.22%（468/2205）;菌株来源主要为呼吸道标本和尿液标本;2012、2013年亚胺培南、美洛培南和厄他培南对产ESBLs肺炎克雷伯菌的耐药率分别为11.17%、4.55%,6.01%、5.38%和9.34%、8.23%;头孢哌酮/舒巴坦、阿米卡星和替加环素对产ESBLs肺炎克雷伯菌的耐药率分别为10.42%、12.65%,4.39%、6.62%和8.70%、11.01%。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、美洛培南、厄他培南、头孢哌酮/舒巴坦、阿米卡星和替加环素。Objective To investigate the drug resistance status of extended-spectrum β-lactamases（ESBLs）-producing Klebsiella pneumoniae, so as to provide scientific evidence for reasonable use of antibiotics in clinic and for prevention and control of nosocomial infection at an early date. Methods The clinical isolated ESBLs-producing Klebsiella pneumoniae date was collected from two grade A comprehensive hospitals from January 2012 to December 2013 in Jiaxing,and then the drug resistance of ESBLs-producing Klebsiella pneumoniae was analyzed. Results A total of 4145 strains of Klebsiella pneumoniae were isolated in two years of January 2012 and December 2013, including ESBLs-producing Klebsiella pneumoniae 855 strains, with the isolation rate of 19.95%（387/1940） and 21.22%（468/2205） in 2012 and2013 separately. The majority of strains were isolated from the respiratory tract specimens and the urine specimens. In2012, 2013 year, the drug resistance rate of the ESBLs-producing Klebsiella pneumoniae to Imipenem was 11.17%,4.55%, Meropenem was 6.01%, 5.38% and Ertapenem was 9.34%, 8.23%; the drug resistance rate of the ESBLs-producing Klebsiella pneumoniae to Cefoperazone-Sulbactam was 10.42%, 12.65%, Amikacin was 4.39%, 6.62% and Tigecycline was 8.70%, 11.01%. Conclusion The drug resistance rate of the ESBLs-producing Klebsiella pneumoniae is signficantly higher than that of the non-ESBLs-producing strains; the Imipenem, Meropenem, Ertapenem, Cefoperazone-Sulbactam, Amikacin and Tigecycline are recommended for the therapy of ESBLs-producing Klebsiella pneumoniae infection.

关 键 词：肺炎克雷伯菌 产超广谱Β-内酰胺酶 耐药性 

分 类 号：R446.5[医药卫生—诊断学]