医院内感染与肺炎杆菌耐药性

NOSOCOMIAL INFECTIONS AND RESISTANCE OF KLEBSIELLA PNEUMONIAE

本文对１９８５～１９８７、１９８８～１９９０年华山医院临床分离的肺炎杆菌进行抗菌药药敏测定及耐药性分析。肺炎杆菌已成为临床分离的革兰氏阳性杆菌常见菌之一，各阶段该菌分别居第２、３和４位。几乎全部菌株均对氨苄西林耐药，但大多对头孢呋新、头孢噻肟、头孢他定和阿米卡星敏感。院内菌株比院外菌株耐药。根据肺炎杆菌对各种氨基糖苷类的敏感性，将测试菌分成产ＡＡＣ（３）－Ⅱ（３１．９％）、产ＡＡＣ（３）－Ⅱ和ＡＡＣ（６′）－Ⅰ（７．７％）和不产ＡＡＣ钝化酶三类。根据药敏测定结果，讨论了肺炎杆菌院内或院外菌株所致感染选用抗菌药的方案。

Klebsiella pneumoniae was one of most common pathage-ns,accounting for 12.2%,10.7% and 7.6% of all bdtcteria isolated at Hua Shaa Hospital,in 1985～1987,1988 and 1989,respectively,The nosocomial strains were more resistant to antimlcrobial agents such as Piperacillin,some Cephalosporins,Gentamicin and Tobramycin,than the community strains.According to susceptibility analysis of 144strains of K. pneumoniae,57 strains(39.6%) produce AAC(3)-Ⅱ, incl-uding 11 strains which also produce AAC(6′)-I.The second and third generation cePhalosporins,alone or in combination with Amikacin.are treatment of cholce for nosocomial infections caused by K. pne-umoniae.