273株肺炎克雷伯菌的分布情况及耐药现状分析  

Analysis of distribution and drug resistance of 273 strains of Klebsiella pneumoniae

作　　者：金泰宇[1] 汪灿 JIN Taiyu;WANG Can(Department of Pharmacy,The Second People's Hospital of Lianyungang,Lianyungang 222006,China)

机构地区：[1]连云港市第二人民医院药学部,江苏连云港222006

出　　处：《中国处方药》2025年第5期45-49,共5页Journal of China Prescription Drug

基　　金：江苏省药学会-天晴医院药学基金项目(Q202047)。

摘　　要：目的分析连云港某医院临床分离的肺炎克雷伯菌的检出情况、临床分布及耐药性,为临床合理使用抗菌药物提供参考依据。方法回顾性分析2020年1月~12月某院临床标本中分离的273株肺炎克雷伯菌的科室分布、标本来源分布及对临床常用抗菌药物的耐药情况。结果临床检出肺炎克雷伯菌菌株共273株,检出率居前三的科室分别为重症医学科(54株)、呼吸内科(50株)、神经内科(31株),分别占19.8%、18.3%、11.4%。标本来源以痰液、尿液、全血、创面分泌物为主,分别占65.6%、14.7%、6.6%、5.5%。药敏实验结果:肺炎克雷伯菌对头孢唑林、氨苄西林/舒巴坦、头孢曲松、复方新诺明耐药率较高,分别为40.0%、39.6%、34.4%、32.2%,对亚胺培南、妥布霉素、阿米卡星耐药率较低,分别为12.8%、12.5%、9.5%。产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌检出率为20.9%。结论某院肺炎克雷伯菌整体耐药情况较为严峻,应加强院内防控管理以及医护人员的培训,减少耐药菌的产生。Objective To analyze the detection,clinical distribution and drug resistance of Klebsiellapneumoniae isolated from clinical specimens of the hospital in Lianyungang,and provide reference for rational use of antibiotics in clinic.Methods The department distribution,specimen source distribution and drug resistance to common clinical antibiotics of 273 Klebsiellapneumoniae strains isolated from clinical specimens in the hospital from January to December 2020 were retrospectively analyzed.Results A total of 273 strains ofKlebsiellapneumoniae were isolated.The top three departments with detection rate were intensive care medicine department(54 strains),respiratory medicine department(50 strains)and neurology department(31 strains),accounting for 19.8%,18.3%and 11.4%,respectively.The source of the specimens were sputum,urine,whole blood,and wound secretions,accounting for 65.6%,14.7%,6.6%,and 5.5%,respectively.The results of drug sensitivity test:Klebsiellapneumoniae showed high resistance rates to cefazolin(40.0%),ampicillin/sulbactam(39.6%),ceftriaxone(34.4%)and cotrimoxazole(32.2%),and low resistance rates to imipenem(12.8%),tobramycin(12.5%)and amikacin(9.5%).The detection rate of extended spectrumβ-lactamases(ESBLs)producingKlebsiellapneumoniaewas 20.9%.Conclusion The overallKlebsiellapneumoniae drug resistance situation in this hospital is relatively severe.Prevention and control management and training of medical staff in the hospital should be strengthened to reduce the generation of drug-resistant bacteria.

关 键 词：肺炎克雷伯菌 耐药性 药敏试验 

分 类 号：R44[医药卫生—诊断学]