2016—2018年某医院产超广谱β-内酰胺酶肺炎克雷伯菌的临床分布及耐药性分析  

Clinical distribution and drug resistance of Klebsiella pneumoniae produced by extended-spectrumβ-lactamase in a hospital from 2016 to 2018

作　　者：马丹娟[1] 黄研 卢春敏[1] 刘艳[1] 邓文喻[1] 周玉晶 黄瑞玉[1] Ma Danjuan;Huang Yan;Lu Chunmin;Liu Yan;Deng Wenyu;Zhou Yujing;Huang Ruiyu(Department of Clinical Laboratory,Guangdong Maternal and Child Health Care Hospital,Guangzhou 510010,China;People's Hospital of Yangdong District,Yangjiang 529500,China)

机构地区：[1]广东省妇幼保健院检验科,广州510010 [2]阳江市阳东区人民医院,529500

出　　处：《国际医药卫生导报》2020年第12期1672-1675,共4页International Medicine and Health Guidance News

基　　金：广东省中医药局科研项目(20161029)。

摘　　要：目的了解某三甲医院产超广谱β-内酰胺酶(extended-spectrum beta-lactamase,ESBLs)肺炎克雷伯菌的临床分布、标本来源及耐药情况,为临床诊治提供依据。方法收集2016年1月至2018年12月某院门诊和住院患者分离的菌株,使用VITEK-Compact 2全自动微生物鉴定系统进行鉴定和药敏实验。采用K-B法进行ESBLs确证试验。应用Whonet 5.6软件进行统计分析。结果共分离出1716株肺炎克雷伯菌,检出产ESBLs 800株,总检出率为46.62%。菌株主要来源于痰液、气管内导管、血液等,科室分布居前3位的是新生儿科、儿科、小儿外科。产ESBLs肺炎克雷伯菌对青霉素类氨苄西林完全耐药;对3代头孢菌素头孢曲松、头孢他啶耐药率分别为97.00%、57.62%;对碳青霉烯类药物、阿米卡星的耐药率较低,低于2.98%。结论肺炎克雷伯菌产ESBLs检出率较高且2016-2018年的耐药率呈明显上升趋势,临床应合理有效地选用抗菌药物,避免产ESBLs菌的院内流行。Objective To determine the clinical distribution,origin,and drug resistance of Klebsiella pneumoniae produced broad-spectrum beta lactamase(extended-spectrum beta-lactamase,ESBLs)in a class-3 hospital between 2016 and 2018,and to provide some evidences for clinical diagnosis and treatment.Methods The strains isolated from the outpatients and inpatients in some hospital from January,2016 to December,2018 were collected.VITEK-Compact 2 automatic microbial identification system was used for identification and drug susceptibility testing.The K-B method was used for ESBLs confirmatory test.Whonet 5.6 software was used for statistical analysis.Results A total of 1716 strains of Klebsiella pneumoniae were isolated,and 800 strains of ESBLs were detected,with a detection rate of 46.62%.The strains mainly came from sputum,endotracheal tube,and blood.The top three departments were departments of newborn,pediatrics,and pediatric surgery.The ESBLs Klebsiella pneumoniae was completely resistant to penicillin(ampicillin).For the third generation cephalosporins,the resistance rates against ceftriaxone and ceftazidime were 97.00%and 57.62%,respectively.The resistance rates of carbapenems and amikacin were lower than 2.98%.Conclusion The detection rate of Klebsiella pneumonia produced-ESBLs is relatively high,and the resistance rate of 2016-2018 years shows an obvious upward trend.Antibiotics should be selected rationally and effectively to avoid the prevalence of ESBLS producing bacteria in hospitals.

关 键 词：肺炎克雷伯菌 产超广谱Β-内酰胺酶 临床分布 耐药性 

分 类 号：R446.5[医药卫生—诊断学]