新生儿病房肺炎克雷伯菌的感染状况及耐药性监测  

Infection status and surveillance of drug resistance of Klebsiella pneumoniae in Neonatal Ward

作　　者：叶青[1] 邓文喻[1] 赖有行[1] 黄瑞玉[1] 穆小萍[1] 

机构地区：[1]广东省妇幼保健院检验科,广东广州510010

出　　处：《中国妇幼保健》2018年第4期823-825,共3页Maternal and Child Health Care of China

基　　金：广东省中医药局资助项目(20161029)

摘　　要：目的探讨肺炎克雷伯菌在新生儿病房中的分布情况及耐药性,为临床抗菌药物的合理选择及调整提供实验室依据。方法选取2014年1月-2016年12月广东省妇幼保健院新生儿科病房住院患者送检标本,标本按照《全国临床检验操作规程》要求进行培养、分离,经全自动细菌鉴定分析系统(VITEK-2 compact)进行鉴定及药敏试验,应用WHONET5.6软件分析药敏结果。结果共分离肺炎克雷伯菌323株,呼吸道标本242株(74.92%);产超广谱β-内酰胺酶(ESBLs)菌株的检出率为70.28%;肺炎克雷伯菌对多种抗生素耐药,其中对亚胺培南的耐药率达14.24%,但对氨基糖苷类、喹诺酮类抗生素均有较高的敏感率。肺炎克雷伯菌对阿米卡星的耐药率最低(0.62%),其次为妥布霉素(1.24%)、左氧氟沙星(4.95%)、庆大霉素(5.26%)、环丙沙星(5.57%)。结论新生儿病房分离出的肺炎克雷伯菌对β-内酰胺类抗生物的耐药率较高,及时掌握病原菌的分布及耐药性,有利于指导临床合理选择抗菌药物,预防医院感染发生。Objective To explore the distribution and drug resistance of Klebsiella pneumoniae in Neonatal Ward,provide a laboratory basis for reasonable selection and adjustment of antibiotics. Methods The samples of hospitalized neonates from Neonatal Ward in Guangdong Provincial Maternal and Child Health Care Hospital from January 2014 to December 2016 were selected,then all the samples were cultured and isolated according to National Clinical Laboratory Procedures,identification and drug sensitive test were carried out through microbial identification and drug sensitivity analysis system（ VITEK-2 compact）. WHONET 5. 6 software was used to analyze the results of drug sensitive test. Results A total of 323 strains of Klebsiella pneumoniae were isolated,and 242 strains（ 74. 92%） were isolated from respiratory tract. The detection rate of extended spectyum β lactamase（ ESBLs） strains was 70. 28%. Klebsiella pneumoniae was resistant to many antibiotics,the drug resistance rate to imipenem was 14. 24%,while the sensitive rates to aminoglycosides and quinolone antibiotics were relatively high. The drug resistance rate to amikacin was the lowest（ 0. 62%）,followed by tobramycin（ 1. 24%）,levofloxacin（ 4. 95%）,gentamicin（ 5. 26%）,and ciprofloxacin（ 5. 57%）. Conclusion The drug resistance rate of Klebsiella pneumoniae to β-lactam antibiotics isolated from Neonatal Ward is relatively high,timely mastering the distribution and drug resistance of pathogens contributes to guiding reasonable selection of antibiotics to prevent the occurrence of nosocomial infection.

关 键 词：新生儿病房 肺炎克雷伯菌 耐药性 

分 类 号：R722.1[医药卫生—儿科]