产超广谱β-内酰胺酶肺炎克雷伯菌耐药性的探讨

Drug Resistance of Extended-spectrumβ-Lactamases(ESBLs) Producing Klebsiella pneumoniae

目的 探讨临床患者分离出来的肺炎克雷伯菌对 11种抗菌药物的耐药性。方法 按照美国临床实验室标准化委员会 (NCCLS)推荐的方法与规则 ,采用浓度梯度法 (E test)测定并比较亚胺培南等 11种抗菌药物对肺炎克雷伯菌的体外抗菌活性。结果 除亚胺培南对产ESBLs和非产ESBLs肺炎克雷伯菌的耐药率均为零外 ,产ESBLs的肺炎克雷伯菌的耐药率显著高于非产ESBLs的肺炎克雷伯菌。结论 临床实验室应将ESBLs作为常规检测项目 ;在治疗包括肺炎克雷伯菌在内的革兰阴性菌严重感染中 ,最敏感的抗菌药物是碳青酶烯类 ,如亚胺培南 ,其次为头孢哌酮 /舒巴坦、哌拉西林

OBJECTIVE To investigate the drug resistance of Klebsiella pneumoniae isolated from inpatients to 11 antibiotics. METHODS According to NCCLS, E test was used to judge antimicrobial activity of K. pneumoniae in vitro to 11 antibiotics,and contrast with them,such as imipenem. RESULTS Besides the drug resistance of ESBLs and non ESBLs producing K. pneumoniae was zero to imipenem,the resistant rates of ESBLs producing strains to most antibiotics were higher than non ESBLs ones. CONCLUSIONS In clinical laboratory, it is necessary to detect if K. pneumoniae produce ESBLs. Imipenem is the most effective antibiotic, and the others are cefoperazone/sulbactam, piperacillin/tazobactam et al.