肺炎克雷伯菌属感染新生患儿的细菌耐药性分析  

Bacterial drug resistance analysis of Klebsiella pneumoniae infection in newborn infants

作　　者：李际红 王健 资捷 

机构地区：[1]深圳市福田区妇幼保健院药剂科,518048 [2]深圳市福田区妇幼保健院新生儿科,518048 [3]深圳市福田区妇幼保健院检验科,518048

出　　处：《齐齐哈尔医学院学报》2016年第20期2573-2575,共3页Journal of Qiqihar Medical University

摘　　要：目的：分析和研究针对新生儿肺炎患者中克雷伯菌的药物的耐药性。通过科学的检测为患儿早期的临床治疗提供有力的根据,在一定程度上保证患儿的治疗,为临床合理的使用抗菌药物奠定坚实的基础。方法选取于2014年1月至2015年12月在我院治疗的新生儿感染肺炎克雷伯菌的患者63例作为此次试验的研究对象。系统的回顾和研究感染肺炎克雷伯菌的新生患儿的具体出生情况以及药物耐药性检验结果。结果本试验研究对象63例感染肺炎克雷伯菌的新生患儿中,胎龄低于37周新生患儿的有14例,37-42周之间的新生患儿39例,〉42周的新生患儿有10例；共分离出的72株肺炎克雷伯菌中,痰液标本占83.3％,产ESBLs阳性率为37.5％,产ESBLs菌株对亚胺培南、左氧氟沙星、哌拉西林/他唑巴坦耐药率较低（分别为0.0％、11.1％、18.5％）,对青霉素类、头孢菌素类抗生素呈现高度耐药性,对磺胺类抗生素、氨基糖苷类也存在较高耐药性,其中对氨苄西林100％耐药。结论新生儿感染肺炎克雷伯菌对青霉素类及头孢菌素类抗生素耐药率较高,产ESBLs菌株对所测试的抗菌药物耐药率明显高于非产ESBLs菌株,产ESBLs菌株多重耐药现象突出,临床应根据药敏试验结果,合理选择抗生素种类,积极有效控制新生儿感染。Objective To analyze and research on drug resistance in patients with neonatal pneumonia Klebsiella, to provide a strong basis for early clinical treatment of children with scientific detection, to a certain extent, to ensure the treatment of children, to lay a solid foundation for clinical rational use of antibiotics. Methods From January 2014 to December 2015, 63 patients in our hospital neonatal infection of Klebsiella pneumoniae as the research object of this experiment. Systematically reviewed and studied the specific circumstances of birth and the results of drug resistance test of newborn infants infected with Klebsiella pneumoniae. Results In this study, 63 cases of newborn infants infected with Klebsiella pneumoniae were studied. There were 14 cases of newborn infants with gestational age less than 37 weeks;between 37 weeks and 42 weeks, there were 39 newborn infants; more than 42 weeks of newborn children with 10 cases. 72 strains of Klebsiella pneumoniae were isolated in sputum accounted for 83. 3%, ESBLs positive rate was 37. 5%, ESBLs producing strained to imipenem and levofloxacin, piperacillin, piperacillin / tazobactam and Jotham resistance rate was low （0.0%, 11.1%, 18.5%）, strained to penicillin and cephalosporin antibiotics appear to be highly resistant to sulfa antibiotics, aminoglycoside had higher resistance, to ampicillin was 100% resistant. Conclusions The resistance rate of Klebsiella pneumoniae to penicillin and the high rate of antibiotics in newborn infants are higher. The resistance rate of ESBLs producing strains to the tested antibiotics is significantly higher than that of non ESBLs producing strains. The phenomenon of multiple drug resistance of ESBLs producing strains is outstanding. In clinic, we should choose antibiotics rationally according to the results of drug sensitivity test, and actively and effectively control the infection of the newborn.

关 键 词：肺炎 克雷伯菌 新生儿 细菌耐药性 

分 类 号：R978.11[医药卫生—药品]