重症监护病房患者大肠埃希菌和肺炎克雷伯菌多重耐药性分析

Clinical investigation of antimicrobial resistance of 280 Escherichia coil and Klebsiella pneumoniae from intensive care units.

目的探讨重症监护病房(ICU)患者大肠埃希菌和肺炎克雷伯菌多重耐药性,为临床提供治疗依据。方法回顾分析ICU病房患者标本中分离的280株大肠埃希菌和肺炎克雷伯菌耐药性。结果大肠埃希菌和肺炎克雷伯菌多数来自痰标本,其中产超广谱β-内酰胺酶(ESBLs)136株(48.6%),产AmpCβ-内酰胺酶10株(3.6%),同时产两种酶2株(1.1%)。抗生素耐药显示携带产ESBLs和AmpC酶菌株都有较高耐药性;产ESBLs菌株对亚胺培南较为敏感(94.8%),其次是哌拉西林/他唑巴坦(36.1%);而AmpC酶菌株对亚胺培南的敏感率仅为48.4%。结论ICU病房大肠埃希菌和肺炎克雷伯菌均有较高的耐药性,因此必须合理应用抗生素。

Objective To investigate the antimicrobial resistance of 280 Escherichia coil and Klebsiella pneumoniae from intensive care units（ ICU ） for selecting antibiotics. Methods The antimicrobial resistance of 280 Escherichia coil and Klebsiella pneumoniae isolated from ICU patients between July 2003 to October 2004 was analyzed. Results Most of Escherichia coll and Klebsiella pneumoniae were from sputum, including 136 strains（48. 6% ） producing ESBLs, 10 strains （3.6% ） were plasmid-incode AmpC,and there were 2 strains（1.1% ） producing both ESBLs and AmpC. The ESBLs were more sensitive to imipenem （ 94.8% ）, and the next was piperacillin/ tazobactam （36.1% ） while the sensitive rate of the AmpC strains to imipenem were only 48.4%. Conclusion The drug resistant rates of Escherichia coil and Klebsiella pneumoniae from ICU are higher so it is important to promote the rational use of antimicrobial agents.