医院感染肺炎克雷伯菌的耐药性调查分析

Drug-resistance of Klebsiella pneumoniae Causing Nosocomial Infections

目的调查医院感染肺炎克雷伯菌的现状及耐药性,为临床医师提供抗感染用药指南。方法肺炎克雷伯菌(KPN)的鉴定严格按照《全国临床检验操作规程》进行;药敏试验采用K-B法;产超广谱β-内酰胺酶(ESBLs)菌株检测采用双纸片协同法和纸片确证试验。结果356株KPN主要分离自呼吸内科、老年病科、神经外科和胸外科;感染标本主要为痰液、咽拭子、尿液和分泌物;KPN产ESBLs率为36.0%;产ESBLs KPN对常用抗菌药物耐药率普遍高于非产ESBLs KPN菌株;未检出对亚胺培南和美罗培南耐药的KPN。结论医院感染肺炎克雷伯菌的耐药性十分严重,应对其加强监测与控制。

OBJECTIVE To investigate drug-resistance status of Klebsiella pneumoniae （KPN） in nosocomial infections and provide the reference for rational application of antibiotics. METHODS According to Nationwide Rules of Clincal Laboratory Manipulation, the strains were identified and drug-sensitivity test was performed by K-B methods. The extended-spectrum-β-1actamases （ESBLs） producing strains were detected by double-disc synergy test and disc confirmed test. RESULTS Totally 356 strains of KPN were mainly isolated from respiratory department, gerontology department, neurosurgery department and chest surgery department. The specimens were mostly sputum, pharynx swab, urine and secretion. The detection rate of ESBLs-producing KPN was 36.0%. The drug-resistance rate to common antibiotics in ESBLs producers was generally higher than that in ESBLs nonproducers. No KPN was resistant to imipenem and meropenem. CONCLUSIONS Drug-resistance status of K. pneumoniae in nosocomial infections is very serious. We should strengthen monitoring and controlling of it.