儿童肺炎克雷伯菌超广谱β-内酰胺酶的检测及药物敏感分析

Detection and drug susceptibility analysis of Klebsiella pneumoniae extended-spectrum beta-lactamase in chirden

目的了解儿童肺炎克雷伯菌感染状况、特点及细菌耐药性分析,以期指导临床合理用药。方法采用VITEK全自动微生物分析鉴定系统对临床分离的肺炎克雷伯菌菌株进行细菌鉴定和药物敏感试验。结果共分离出肺炎克雷伯菌122株,其中产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌62株(50.82%),不产ESBLs肺炎克雷伯菌60株(49.18%);产ESBLs肺炎克雷伯菌62株中有45株(72.58%)从痰液分离中得到。分离出来的产ESBLs肺炎克雷伯菌菌株对青霉素类抗生素如氨苄西林、替卡西林及头孢噻吩完全耐药,对头孢西丁和亚胺培南完全敏感;分离出来的不产ESBLs肺炎克雷伯菌菌株对青霉素类抗生素氨苄西林完全耐药,对头孢西丁和亚胺培南完全敏感。结论肺炎克雷伯菌产ESBLs率较高;临床治疗前应尽可能进行肺炎克雷伯菌培养及药敏试验,以合理和规范用药。

Objective To understand the state and feature of infection and bacterial drug resistance analysis of Klebsiella pneumoniae in chirden in order to conduct the proper clinical application. Methods The bacteria identification and drug sensitivity test of Klebsiella pneumoniae were done with VITEK automatic microbial analysis identification system. Results 122 strains of Klebsella basillus were separated, including 62 strains of producing extended-spectrum beta-lactamase （ ESBLs ） Klebsella basillus （50.82%） and 60 strains of not producing ESBLs Klebsella basillus （49. 18% ） ;There were 45 strains （72. 58% ） of producing ESBLs Klebsella basillus were separated form sputum, Producing ESBLs Klebsella basillus were completely resistant to ampicillin, ticarcillin and cafalotin, and were wholly sensitive to cefoxitin and imipenem. Not producing ESBLs Klebsella basillus were completely resistant to ampicillin, and were wholly sensitive to cefoxitin and imipenem. Conclusion The rate of producing ESBLs Klebsella basillus is higher. Cultivation and susceptibility test of Klebsella basillus should be done before clinical treatment in order to guide clinical reasonable and regulating drug use.