肺炎克雷伯菌医院感染及耐药性分析

Nosocomial Infection and Drug Resistance of Klebsiella Pneumonia

目的了解肺炎克雷伯菌的感染分布及耐药状况,为临床治疗提供依据.方法采用回顾性的方法,统计分析199株肺炎克雷伯菌的标本来源、感染科室分布、产超广谱β-内酰胺酶(ESBLs)株的检出率、产ESBLs株和非产ESBLs株的耐药状况比较.结果199株肺炎克雷伯菌主来要自痰液,占60.30%.感染科室分布以ICU和呼吸内科为主,分别占28.14%和26.63%,产ESBLs株表现出多重耐药,除对亚胺培南表现出与非产ESBLs株一样的高度敏感性外,对头孢菌素类、青霉素类、氨基糖甙类、喹诺酮类抗菌药物耐药率均非常高,与非产ESBLs株相比差异有统计学意义(P<0.01).结论肺炎克雷伯菌产ESBLs株多重耐药性明显,医生应慎重使用头孢菌素类抗生素,根据药敏结果合理使用抗菌药物,减少医院感染的发生和流行.

Objective To investigate the characteristics of nosocomiai infection of Klebsiella pneumonia （K.pneumonia） and its drug resistance, and to provide scientific evidence for clinical reasonable usage of antibiotics. Method We analyzed retrospectively the source of specimen and its infection distribution of 199 patients with K.pneumonia, the detection rate of ESBLs producing strains, drug resistance of producing and Non-producing strains of ESBLs. Results 199 strains of K. pneumoniae were mostly from the sputum, accountting for 60.30%. Infection caused by K.pneumoniae were frequently occurred in Intensive care units （ICU 28.14% ） and Department of respiratory （26.63%） , ESBLs producing strains showed multi-drug resistance, The resistant rates of ESBLs producing strains to Cephalosporins, Penicillins, Aminoglycosides, Quinolones were very high, there was a significant （P 〈0.01） relationship between producing and Non-producing strains of ESBLs. Conclusions ESBLs producing strains of K.pneumoniae have multi-drug resistance apparently. Besides, non-ESBLs-producing strains of K.pneumoniae have higher sensitivity to Imipenem. Rational usage of antibacterial drugs can reduce hospital infections.