肺炎克雷伯菌的临床分布与耐药性分析  

Clinical distribution and drug resistance of Klebsiella pneumoniae isolates

作　　者：谢强[1] 曹明杰[1] 陈玲[1] 徐添天 马筱玲[3] 

机构地区：[1]滁州市第一人民医院检验科,安徽滁州239000 [2]滁州市第二人民医院检验科,安徽滁州239000 [3]安徽省立医院检验科,安徽合肥230001

出　　处：《中华医院感染学杂志》2015年第17期3854-3855,3889,共3页Chinese Journal of Nosocomiology

基　　金：安徽省自然科学基金资助项目(1408085MH188)

摘　　要：目的了解医院肺炎克雷伯菌的临床分布及耐药性,为临床合理用药提供参考。方法回顾性分析2013年临床各类标本分离的242株肺炎克雷伯菌分布及耐药性;使用WHONET5.6软件进行统计分析。结果 242株肺炎克雷伯菌主要分离自痰液、分泌物和中段尿,分别占67.8%、18.2%和7.9%;科室分布以ICU、儿科、呼吸内科和神经内科为主,分别占21.5%、16.5%、11.6%和10.7%;242株肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)检出78株,检出率为32.2%;产ESBLs菌株对18种抗菌药物的耐药率明显高于非产ESBLs菌株。结论医院分离的肺炎克雷伯菌耐药严重,尤其是产ESBLs菌株感染多药耐药严重,微生物室应加强对产ESBLs菌株的耐药性监测。OBJECTIVE To investigate the clinical distribution and drug resistance of the Klebsiella pneumoniae isolates so as to provide guidance for reasonable clinical use of antibiotics.METHODS The distribution and drug resistance of 242 strains of K.pneumoniaethat were isolated from various clinical specimens were retrospectively analyzed,and the statistical analysis was performed with the use of WHONET5.6software.RESULTS Of the 242 strains of K.pneumoniae,67.8% were isolated from the sputum specimens,18.2% were isolated from the secretions,and 7.9% were isolated from the midstream urine specimens.As for the distribution of the strains in the clinical departments,21.5% were isolated from the ICU,16.5% were isolated from the department of pediatrics,11.6% were isolated from the department of respiratory medicine,and 10.7% were isolated from the department of neurology.Totally 78 strains of extended-spectrumβ-lactamases（ESBLs）-producing K.pneumoniae were detected among the 242 strains of K.pneumoniae,with the detection rate of 32.2%.The drug resistance rates of the ESBLs-producing K.pneumoniae strains to 18 antibiotics were significantly higher than those of the non-ESBLsproducing K.pneumoniae strains.CONCLUSIONThe clinical K.pneumoniaeisolates are highly resistant to the antibiotics,and the ESBLs-producing K.pneumoniae strains are highly multidrug-resistant.It is necessary for the microbial laboratory to strengthen the surveillance of the drug resistance of the ESBLs-producing K.pneumoniae strains.

关 键 词：肺炎克雷伯菌 超广谱Β-内酰胺酶 耐药性 

分 类 号：R378[医药卫生—病原生物学]