产超广谱β-内酰胺酶肺炎克雷伯菌感染分布及耐药性监测

Distribution and Drug Resistance Status of Extended-Spectrum β-Lactamases Producing Klebsiella pneumoniae

目的调查产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌(KPN)感染的分布及耐药现状,为临床抗感染治疗提供依据。方法采用ATB-Experssion分析仪进行细菌鉴定,K-B法进行药敏试验,并用纸片扩散法确证试验检测ESBLs。结果检出137株KPN,其中产ESBLs 47株,以老年病科检出率最高;产ESBLs KPN耐药率显著高于非产ESBLs菌,亚胺培南可作为肺炎克雷伯菌重症感染的首选抗菌药物。结论KPN耐药严重,应重视ESBLs的检测,根据药敏结果合理选用抗菌药物,控制产ESBLs细菌的传播。

OBJECTIVE To investigate the distribution and drug resistance status of extended-spectrum β-1actamases producing （ESBLs） Klebsiella pneumoniae and to provide the basis for clinic anti-infective treatment. METHODS To use ATB-expression analyzer to identify the microbe. The drug susceptibility was tested with the K-B method and the ESBLs producing strains detected by diffusion confirmed test. RESULTS Among 137 strains of identified K. pneumoniae, 34.3% of them（47 strains）produced ESBLs, and most had been shown in geriatrics ward. The drug resistance rate of ESBLs producing K. pneumoniae was higher than that in non-producing ESBLs one. So imipenem should be considered to be a preferred antibiotic when used on K. pneurnoniae seriously infected cases. CONCLUSIONS The drug resistance of K. pneurnoniae is a serious problem, we should pay attention on the status of ESBLs distribution, based on the susceptibility to choose the reasonable antibacterial to avoid the producing ESBLs bacteria spread out.