产ESBL克雷伯菌属在院内耐药性研究  

Study on Drug Resistance of ESBL-producing Klebsiella in Hospital

作　　者：杨倩 赵志国[2] 石彪[2] 梅艳芳[2] 姜岩松 YANG Qian;ZHAO Zhiguo;SHI Biao;MEI Yanfang;JIANG Yansong(Second Clinical College of Chengde Medical College,Hebei Chengde 067000,China;Chengde Centre Hospital,Hebei Chengde 067000,China)

机构地区：[1]承德医学院第二临床学院,河北承德067000 [2]承德市中心医院,河北承德067000

出　　处：《临床医药文献电子杂志》2018年第52期19-20,共2页Electronic Journal of Clinical Medical Literature

摘　　要：目的研究我院产超广谱β-内酰胺酶(extended spectrum beta lactamase ESBL)克雷伯菌属临床分布及耐药情况。方法选择2015年1月~2017年12月承德市中心医院所有检出的产ESBL克雷伯菌属细菌,使用法国生物梅里埃公司VITEK2-compact全自动微生物分析仪及美国临床和实验室标准化协会(CLSI)推荐的方法对其进行鉴定及药敏试验,结果使用WHONET5.6软件进行统计分析。结果 2015年1月~2017年12月我院产ESBL克雷伯菌属检出率分别为2.73%、2.86%、3.34%。3年共分离产ESBL克雷伯菌属细菌182株,主要为肺炎克雷伯菌89.01%(162株),标本来源主要为痰(59.89%)和尿液(28.02%)。分布于医院的多个科室,主要为神经外科(18.13%)、重症医学科(18.13%)、泌尿外科(10.99%)、呼吸内科(9.89%)。结论我院产ESBL克雷伯菌属细菌检出率逐渐增加,耐药性逐渐增强,耐药机制不断变迁,这与我院抗菌药物不规范使用、侵入性操作日益增多有关,因此规范临床合理使用抗菌药物,减少侵入性操作的机会,将会减少或减缓耐药菌株的产生。Objective To analyze the clinical distribution and drug resistance of extended-spectrumβ-lactamases producing Klebsiella.Methods All ESBL-producing Klebsiella were detected in Chengde Central Hospital from January 2015 to December 2017.All the isolates were identified by VITEK-2 Compact Automatic Microbial Identification Analyzer(Bio Merieux,France)and the methods recommended by the Clinical and Laboratory Standards Institute(CLSI).The statistic informations were analyzed by WHONET 5.6 software.Results The detection rate of ESBL-producing Klebsiella in our hospital from January 2015 to December 2017 was 2.73%2.86%and 3.34%espectively.A total of 182strains of ESBL-producing Klebsiella were isolated in 3 years,162 stains were Klebsiella pneumoniae(89.01%).The specimens were mainly derived from sputum(59.89%)and urine(28.02%).They were isolated from various departments of the hospital,mainly including neurosurgery ward(18.13%)、intensive care unit(18.13%)、urinary surgery ward(10.99)、pneumology department(9.89%).Conclusion The detection rate of ESBL-producing Klebsiella in our hospital is increasing,drug resistance is gradually increasing,the mechanism of drug resistance is constantly changing,This is related to the irregular use of antimicrobial drugs and the increasing number of invasive operations in our hospital.Wherefore,standardizing the rational use of antimicrobial agents in clinical practice and reducing the chances of invasive manipulation will reduce or slow down the production of drug-resistant strains.

关 键 词：克雷伯菌属 超广谱Β-内酰胺酶 耐药性 

分 类 号：R446[医药卫生—诊断学]