2011年-2015年商丘市肺炎克雷伯菌临床分布及其耐药性研究  

Study of clinical distribution and drug resistance of Klebsiella pneumoniae from 2011 to 2015 in Shangqiu

作　　者：张爱荣[1] 许青霞[2] ZHANG Ai - rong XU Qing - xia(The First People＇s Hospital of Shangqiu, Shangqiu, Henan 476100, China)

机构地区：[1]商丘市第一人民医院,河南商丘476100 [2]河南省肿瘤医院,河南郑州450008

出　　处：《中国卫生检验杂志》2017年第9期1344-1346,1350,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨本院最近5年临床分离肺炎克雷伯菌的临床分布及其耐药性特点。方法收集本院2011年-2015年临床分离的肺炎克雷伯菌,药敏试验采用K-B法,实验结果按照美国临床实验室标准协会(CLSI)2014年M100-S24标准,数据分析采用WHONET 5.6软件。结果 5年共收集肺炎克雷伯菌非重复菌株2 082株,主要来源于呼吸道、伤口、泌尿系感染患者标本。肺炎克雷伯菌耐药机制复杂,常常多种耐药机制同时存在。产ESBLS是肺炎克雷伯菌耐药的主要机制,5年间检出率为47.8%~58.0%;产酶菌株耐药性明显高于非产酶菌株。碳青霉烯类抗生素、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星和左氧氟沙星对肺炎克雷伯菌仍然保持较好的抗菌活性。结论肺炎克雷伯菌耐药机制复杂,主要引起呼吸道、伤口和尿路感染;要高度重视重症患者耐碳青霉烯肺炎克雷伯菌的感染,加强其实验室监测和感染控制,严防其在医疗环境中感染的播散。Objective To study the distribution and drug resistance characteristics of Klebsiella pneumonia during recent 5 years in our hospital. Methods KlebsieUa pneumonia strains isolated from clinical in our hospital during 2011 - 2015 were collected, and the drug susceptibility testing was conducted using Kirby - Bauer method WHONET 5.6 was used to analyze the data according to 2014 CLSI breakpoints. Results A total of 2 082 no - repeat strains of Klebsiella pneumonia were mainly collected from the respiratory tract, wound and urinary tract infection patients. The resistant mechanism of Klebsiella pneumoniae was complex, with many resistant mechanisms existing at the same time. Producing extended -spectrum 13 -lactamase（ESBLs） was the main mechanism of drug resistance in Klebsiella pneumoniae, with the detection rate of 47.8% - 58.0% during the 5 years. The resistance of ESBLs - producing strains were significantly higher than that non - producing strains. Carbapenems, cefoperazone - sulbactam, piperacillin - tazobactam, amikacin and levofloxacin remained better activity to Klebsiella pneumoniae. Conclusion The resistant mechanism in Klebsiella pneumoniae was complicated, which mainly caused respiratory tract, the wound and urinary tract infection. We should not only pay high attention to the severe patients infection with CRKP, but also strengthen its laboratory monitoring and control on it＇ s infection, so as to prevent it spread in the medical environment.

关 键 词：肺炎克雷伯菌 临床分布 耐药性 

分 类 号：R446.5[医药卫生—诊断学]