不同标本分离的肺炎克雷伯菌的耐药性比较及分析

Clinical Distribution and Resistance of K.pneumoniae in Hospital an Analysis

目的:了解肺炎克雷伯菌在临床不同标本中的耐药性特点及差异。方法:对临床各类标本进行常规微生物培养及药敏试验。结果:共检出肺炎克雷伯菌315株,ESBLs菌株47株。在痰中检出242株、中段尿31株、血15株、咽拭子10株、分泌物8株及脓液9株。在15种抗菌药物的药敏结果中,耐药率>70%的抗生素有2种,亚胺配南耐药率最低(5.7%)。产ESBLs菌株对多种抗菌药物的耐药率显著高于非产ESBLs菌株(P<0.05)。同一抗生素对于不同标本分离的肺炎克雷伯菌显示出不同的敏感性。结论:临床医生选用抗生素时,应综合考虑各种因素。

Objective： To investigate the clinical distribution of the infection by K. pneumoniae and the antimicrobial resistance. Methods： Bacteria were detected using bio Merieux VITTEK-2 system. Results： A total of 315 strains of K. pneumoniae, and ESBLs producing strains were 47. Resistant rates over 70% added up to 2 among the 15 tested antimicrobial agents. The lowest of resistant rates was imipenem （5.7%）. Resistant rates of ESBLs producing strains were much higher than ESBLs nonproducing strain （P 〈 0. 05 ）. The difference of sensitivety to a antibiotics of K. pneumonine was analyzed for different site of infection. Conclusion： More attention to the surveillance of antimicrobial resistance of K. pneumoniae in clinics and preventing transmission or epidemic of their resistant strains should be given.