新生儿NICU病房肺炎克雷伯菌产超广谱β内酰胺酶的检测及耐药性分析

Detection of Extended-Spectrum Beta-Lactamases Producing K. peumoniae and Analysis of Antibiotic Resistance in the Newborn Intensive Care Unit

目的了解深圳市宝安区龙华医院新生儿病房产ESBLs肺炎克雷伯菌的耐药情况,为合理治疗提供依据。方法对该院新生儿重症监护病房2006年1月-2007年12月收治的新生儿各类标本中分离所得169株肺炎克雷伯菌,采用纸片扩散表型确证试验进行ESBLs检测,采用美国DADE Micro Scan Walkaway-40全自动微生物鉴定药敏测定系统进行药敏试验。结果肺炎克雷伯菌产ESBLs率由19%上升到32%,产ESBLs株耐药性显著高于非产ESBLs株;产ESBLs株仅对四代头孢菌素类、亚胺培南敏感。结论该院新生儿重症监护病房中产ESBLs的肺炎克雷伯菌逐年上升,应根据药敏结果结合临床合理使用抗生素;同时应采取有效措施控制产ESBLs肺炎克雷伯菌在新生儿重症监护病房感染。

Objective To study the occurrence of antibiotic resistant K. peumoniae in the newborn intensive care unit and to provide appropriate measures in clinical practice. Methods 169 strains of K. peumonioe were collected from the patients in the newborn intensive care unit of Longhua Hospital during the years 2006 and 2007. Extended-spectrum beta-lactamases （ESBLs） test was determined by the disc diffusion method. Antibiotic susceptibility test was performed using the DADE Micro Scan Walkaway-40 system. Results ESBLs producing strain was increased from 19% to 32% during the years 2006 and 2007. Drug resistance of ESBLs producing strains was higher than the non-ESBLs producing strains. ESBLs producing strains were only sensitive to the forth-generation cephalosporins and imipenem. Conclusion The frequency of ESBLs producing K. peumoniae in the newbom intensive care unit of Longhua Hospital was increasing in 2007. Proper use of antibiotics and adoption of effective measures can prevent the spread of K. peumoniae in the newborn intensive care unit.