湖北地区三级医院儿童感染克雷伯菌属的耐药性监测

Monitoring of Antibiotic Resistance of Klebsiella pneumoniae Isolated from Children in Tertial Level Hospitals in Hubei Province

目的调查2003～2007年湖北地区三级医院儿童感染克雷伯菌属细菌的耐药性变迁，为儿科临床医师合理使用抗菌药物提供科学依据。方法采用WHONET4—5软件对2454株克雷伯菌属细菌的耐药率进行统计分析。结果湖北地区儿童组克雷伯菌属细菌的耐药率低于成人组，对常用抗菌药物的耐药率多呈上升趋势；对氨苄西林耐药率最高，达93．0％～97．0％；对亚胺培南和美罗培南敏感率最高，为100．0％；耐药率较高的抗菌药物有哌拉西林、头孢唑林、头孢呋辛、头孢噻肟（41．0％～66．0％）；耐药率较低的抗菌药物有阿米卡星、左氧氟沙星、环丙沙星、哌拉西林／他唑巴坦、头孢哌酮／舒巴坦、头孢西丁（5．0％～20．0％）。结论结合儿童的生理特点，应采取有效措施，合理使用抗菌药物，控制耐药菌的产生与暴发流行。

OBJECTIVE To investigate the antibiotic resistance changing of Klebsiella pneumoniae isolated from children in Hubei tertial level hospitals from 2003 to 2007 dynamically and provide the reference for clinical application of antibiotics. METHODS The WHONET4-5 software was used to analyze the antibiotic resistant rates in 2454 K. pneumoniae strains. RESULTS The resistance rate in K. pneumoniae strains in children group was lower than that in adult group. The resistance rates of the commonly used antibiotics showed the ascending tendency. 93.0-97.0% of K. pneumoniae isolates were resistant to ampicillin with the highest resistance rate. 100% of them were susceptible to imipenem and meropenem with the highest susceptibility. The antibiotics with higher resistant rate （41. 0-66. 0%） comprised piperaeillin, cephazoline, cefuroxime and cefotaxime. But the resistance rates to amikacin, levofloxacin, ciprofloxacin, piperacillin/tazobactam, cefoperazone/sulbactam and cefoxitin were lower, 5. 0-20. 0%. CONCLUSIONS We should take effective measurement to use antibiotics reasonably in combination with children＇s physiological characteristics and control the occurrence and outbreak epidemic of resistant bacteria.