新疆乌鲁木齐地区产超广谱β-内酰胺酶肺炎克雷伯菌的检测及耐药性分析

Detection of Extended Spectrum β-lactamase Klebsiella Pneumoniae Isolated from Patients in Urumqi and Their Drug Resistance

目的了解新疆乌鲁木齐地区产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌的检出率及其耐药情况,指导临床合理选择抗菌药物。方法菌株鉴定采用VITEKTWO全自动微生物分析仪,K-B纸片扩散法进行药敏试验,ESBLs采用双纸片增效法,对一年来新疆医科大学第一附属医院肺炎克雷伯菌的耐药谱进行回顾性调查。结果共检出391株肺炎克雷伯菌,经确认试验,产ESBLs菌株167株,其阳性率为42.71%。产ESBLs肺炎克雷伯菌对青霉素类药物耐药率最高,对氨苄西林的耐药率高达100.00%;对亚胺培南的耐药率最低,对美洛培南及哌拉西林/他唑巴坦、头孢哌酮/舒巴坦也显示出较高的敏感性;对氨基糖苷类、氟喹诺酮类、磺胺类等药物具有较高的多重耐药性。结论肺炎克雷伯菌产ESBLs阳性率及多重耐药率高,对大多数抗菌药物耐药且呈多重耐药,亚胺培南、β-内酰胺酶抑制剂复合物可用于控制肺炎克雷伯菌引起的感染。

Objective To analyze the detection rates and antimicrobial resistance of extended spectrumβ-lactamases(ESBLs)klebsiella pneumoniae(KP) isolated from patients in Urumqi district,to provide references for rational use of antimicrobial agents in clinic.Methods The strains were identified by VITEK TWO automatic microorganism analyzing system,drug sensitive test by K-B disk diffusion procedure,ESBLs by double-disk synergy test,and a retrospective investigation was performed on the resistance spectrum of clinical KP isolates in the First Affilied Hospital of XinJiang Medical University.Results Three hundred ninety-one KP strains were detected with a positive rate of 42.71%.KP producing ESBLs was the most resistant to Penicillins(to Ampicillin as high as 100.00%),the lowest to imipenem,and showed relatively high sensitivity to Meropenem,Piperacillin/Tazobactam,cefoperazone/sulbactam;KP had a high multidrug resistance(MDR) to aminoglycosides,fluoroquinolones,sulfonamides.Conclusion KP,which has a high rate of positive ESBLs,is resistant or multi-resistant to most antimicrobial agents.Imipenem and β-lactamase inhibitor compounds can be used to control infection caused by KP.