肺炎克雷伯菌在医院环境中的分布及耐药性分析  

The distribution and drug resistance analysis of Klebsiella pneumoniae in hospital environment

作　　者：仇广翠[1] 孙明忠[1] 邵良荣[1] 金浩[1] 陆强[1] 

机构地区：[1]东南大学医学院附属盐城医院检验科,江苏盐城224001

出　　处：《检验医学》2015年第2期160-162,166,共4页Laboratory Medicine

摘　　要：目的了解江苏盐城地区三级医疗机构环境中肺炎克雷伯菌的分布和耐药性,为加强控制医院内感染和临床合理使用抗菌药物提供依据。方法采用法国生物梅里埃公司的VITEK-32全自动微生物仪对627例标本进行肺炎克雷伯菌鉴定。并用纸片扩散法(K-B)进行药物敏感性试验检测,采用美国临床实验室标准化协会(CLSI)推荐的标准纸片扩散法检测产超广谱β-内酰胺酶(ESBLs)。结果从627例标本中共检出213株肺炎克雷伯菌,检出率为33.97%。肺炎克雷伯菌在医院环境中的分布以内科病房最高为66.67%,其次为妇产科病房及治疗室分别为43.84%、43.08%;肺炎克雷伯菌对青霉素类氨苄西林和阿莫西林耐药率高达96.70%和99.73%;产ESBLs菌株占34.27%(73/213)。结论医院环境中肺炎克雷伯菌污染较重,耐药率高,耐药谱广。应加强医院环境消毒,加强监测,严格控制院内感染的发生与流行。Objective To investigate the distribution and drug resistance of Klebsiella pneumoniae in the three-tier medical institutes of Yancheng city,in order to provide the reference for the prevention of nosocomial infection and the rational use of antibiotics. Methods Klebsiella pneumoniae was determined by VITEK-32 automatic microorganism analyzer,which was produced by France Bio Merieux Company. A total of 627 samples were used for Klebsiella pneumoniae determination. Drug sensitivity test of Klebsiella pneumoniae was performed by disk diffusion（ K-B）method. Standard disk diffusion method suggested by the Clinical and Laboratory Standards Institute（ CLSI） was employed to conduct the extended-spectrum beta lactamase（ ESBL） test. Results A total of 213 Klebsiella pneumoniae positive samples were determined from the 627 samples. The positive rate was 33. 97%. The highest prevalence of Klebsiella pneumoniae positive samples was observed in the ward of Internal Medicine Department（ 66. 67%）,followed by Department of Obstetrics and Gynecology（ 43. 84%） and Treatment Room（ 43. 08%）. The resistance rates of Klebsiella pneumoniae to ampicillin and amoxicillin were 96. 70% and 99. 73%,respectively. A total of 34. 27%（ 73 /213） of the determined Klebsiella pneumoniae was ESBL-produced Klebsiella pneumoniae. Conclusions The pollution of Klebsiella pneumoniae is common in medical environment with high resistance rate. In order to control the nosocomial infection of Klebsiella pneumoniae,hospital environment disinfection and inspection for Klebsiella pneumoniae pollution are needed to be further strengthened.

关 键 词：肺炎克雷伯菌 医院环境污染 耐药性 产超广谱Β-内酰胺酶 

分 类 号：R446.5[医药卫生—诊断学]