新生儿肺炎克雷伯菌肺炎药敏分析

Study on drug resistance newborn of klebsiella pneumoniae

目的了解新生儿肺炎克雷伯菌肺炎的药敏情况，及产超广谱B-内酰胺酶（ESBLs）的发生率，为合理使用抗生素治疗提供依据。方法收集本院2008年8月-2009年5月新生儿肺炎克雷伯菌肺炎71例痰液标本，采用法同BioMerieux VITEK2 Compact全自动细菌鉴定仪对临床分离菌株进行鉴定及药敏检测，以及超广谱-β内酰胺酶（ESBLs）的检测，对其临床资料进行回顾性分析。结果肺炎克雷伯菌ESBLs发生率为71．8％肺炎克雷伯菌对亚胺培南、头孢替坦敏感率达100％，对近几年在新生儿较少用的阿米卡星、环丙沙星的敏感率为80％～90％，而对常用氦苄西林不敏感，对头孢菌素敏感率低。产ESBLs菌株耐药性比非产ESBLs菌株强。结论新生儿肺炎克雷伯菌中为产ESBLs菌株比例较高，耐荮胜强。应根据药敏试验结果选择敏感抗生素，及时控制疾病的发展，降低病死率.

Objective To probe into the drug sensitivity about newborn pneumonia of Klebsiella pneumoniae（Kp） and inves-tigate the positive rate of extended-spectrum β-laetamases（ESBLs） in klebsiella pneumoniae.and provide the evidence of reasonable treatment. Method 71 eases of sputum samples newborn pneumonia ofklebsiella pneumoniae from july2008 to may2009 were collected use BioMerieux VITEK2 Compact to Bacteria identification and drug sensitivity testwere per-formed. At the same time, ESBLs were detected.Results the positive rate of ESBLs in klebsiella pneumoniae was 71.8 %, Kp was 100%sensitive to earbopenems,e.g lmipenen,Meropenen,and 80%-90%to Amikaein and Ciprofloxaein,whieh were hardly used in newboru recent years.While it was resistant to commonly used Penicillin and Cephalosporin.. ESBLs negative strains had higher drug sensitivity than ESBLs strain.Conclusions Partial klebsiella pneumoniae are ESBLs strains and insensitive to commonly used antibiotics. In order to decrease ESBLs strains, the antibiotics Ireatment shall be used appropriately and the seleetion of antibiotics shallbe guided by the results ofdrug sensitivity tests.