广州地区肺炎克雷伯菌分布和耐药性调查

Study of the distribution and antimicrobial resistance of Klebsiella pneumoniae in the Guangzhou area

目的:了解广州地区肺炎克雷伯菌分布和耐药情况,指导临床合理选择抗菌药物。方法:对广州地区1999-2004年从临床分离的1556株肺炎克雷伯菌采用纸片扩散法药敏试验,用WHONET5.3软件进行统计分析。结果:718株(46.1%)分离自痰标本,从尿液和血液分离到261株(16.8%)和164株(10.5%);对亚胺培南的敏感率最高,其次是头孢吡肟,产超广谱β-内酰胺酶的比率达41.3%～44.7%;从尿液中分离的肺炎克雷伯菌对各种抗菌药物的耐药率明显高于从其它部位分离的菌株。结论:本地区肺炎克雷伯菌临床分离株对抗菌药物耐药率较高,合理使用抗菌药物是当务之急。

Objective To investigate the distribution and antimicrobial resistance of KlebsieUa pneumoniae in the Guangzhou area and provide clinical guidelines for the rational use of antimicrobial agents. Methods 1 556 strains of Klebsiella pneumoniae were isolated from 1999 to 2004 in the Guangzhou area and the antibacterial susceptibility testing for these isolates was performed by disk diffusion method. The results were analyzed by the WHONET 5.3 computer program. Results 718（46. I% ） strains were isolated from sputum, 261 （16. 8% ） from urine, and 164 （10. 5% ） from blood samples, respectively. Imipenem was the most sensitive antimicrobial agent against KlebsieUa pneumoniae infection, followed by cefepime. The prevalence of extended-spectrum beta-lactamaese was 41.3% - 44.7%. The multi-drug resistance rate of KlebsieUa pneumoniae from urine samples was significantly higher than that from other samples. Conclusions The clinical isolates of KlebsieUa pneumoniae have a higher drug resistance in the Guangzhou area. It is urgent to have antibiotics used reasonably.