基层医院呼吸内科肺炎克雷伯菌感染现况和耐药性分析  

Study on Klebsiella pneumonia infection and drug susceptibility in department of respiratory medicine in primary hospital

作　　者：黄健云[1] 芮勇宇[1] 莫和国[2] 黎泳仪 陆小琴[2] 欧水连[2] 邴晏如[2] 

机构地区：[1]南方医科大学南方医院检验科,广州510515 [2]南方医科大学附属小榄医院检验科,中山528415

出　　处：《国际呼吸杂志》2015年第12期904-906,共3页International Journal of Respiration

基　　金：中山市医学科研基金项目（2009063）

摘　　要：目的：了解基层医院呼吸内科肺炎克雷伯菌的耐药现况和评价《抗菌药物临床应用专项整治活动方案》的实施效果，为临床医师合理应用抗菌药物提供科学依据。方法用 VITEK2微生物分析系统对本院2012年1月至2013年12月呼吸内科标本中分离的肺炎克雷伯菌进行药敏分析，比较分析《抗菌药物临床应用专项整治活动方案》干预前（2012年）和干预后（2013年）呼吸内科肺炎克雷伯菌的耐药性。结果2012年（干预前）和2013年（干预后）从本院呼吸内科标本分离的肺炎克雷伯菌分别为73株和58株，其主要来源于呼吸系统感染，分别占91.8%和82.8%；该项方案干预后，产超广谱β-内酰胺酶肺炎克雷伯菌检出率由27.4%降为20.7%，其对常用β-内酰胺类药物的耐药率低于干预前，尤其是氨曲南、氨苄西林/舒巴坦、头孢唑啉、头孢呋辛、头孢曲松、头孢他啶和头孢吡肟的耐药率显著降低（P 〈0.05）。结论该项方案干预后，呼吸内科标本分离的肺炎克雷伯菌对常用13种抗菌药物耐药率低于干预前，其中有10种抗菌药物的耐药率显著降低。Objective To investigate the current situation of Klebsiella pneumonia infection in the department of respiratory medicine and evaluate the effect of resistance control project which was performed in our hospital to use antibiotics scientifically.Methods The drug sensitivity analysis were performed by VITEK-2 microbiology analysis system.Situation of drug resistance of Klebsiella pneumonia isolated from the samples of the department of respiratory medicine in 2012 （before the project executed） was compared with that in 2013（after the project executed）.Results 73 strains of Klebsiella pneumonia were isolated from the department of respiratory medicine in 2012 （before the project executed）and 58 strains in 2013 （after the project executed）respectively.These strains were isolated majorly from the samples of respiratory infection,91.8% in 2012 and 82.8% in 2013.The detection rate of extend spectrunβ-lactamases-producing strains was 27.4% in 2012 and 20.7% in 2013.The resistance rate of Klebsiella pneumonia to bata-lactamases in 2012 was higher than that in 2013.The resistance rates of aztreonam, ampicillin/sulbactam,cefazolin,cefuroxime,cefatriaxone,ceftazidime,and cefepime decreased distinctly （P 〈0.05）.Conclusions The drug resistance rates of Klebsiella pneumonia to 13 kinds of antibacterial drugs in 2013（after the project executed）were lower than those in 2012 （before the project executed）in the department of respiratory medicine.The drug resistance rate of Klebsiella pneumonia to ten kinds of antibacterial drugs decreased distinctly.

关 键 词：肺炎克雷伯菌 药物抗药性 超广谱Β-内酰胺酶 

分 类 号：R631[医药卫生—外科学]