我院临床标本中肺炎克雷伯菌分布及耐药性分析

Analysis of distribution and resistantce of the K.pneumoniae in our hospital

目的了解近2年来肺炎克雷伯菌标本的来源构成及耐药情况,以指导临床合理用药。方法对2008年1月至2009年12月间的各类临床标本进行分离培养,用天地人微生物分析系统生化试验卡鉴定,并用天地人微生物分析系统相配套的药敏试验卡进行药敏试验。结果共分离肺炎克雷伯菌213株;主要来源于痰标本(54.46%);连续2年对美洛培南无耐药株,耐药率低的其次是阿米卡星(8.45%)、哌拉西林/他唑巴坦(12.21%);对氨苄西林耐药率为100%。肺炎克雷伯菌ESBLs阳性率为22.54%,产ESBLs肺炎克雷伯菌的耐药率远远高于非产ESBLs的菌株。结论美洛培南是治疗产ES-BLs肺炎克雷伯菌的首选药物。应采取相应的措施控制肺炎克雷伯菌导致的医院感染流行及产ESBLs菌株的产生。

Objective To investigate the composing of origin and resistantce circs of the K.pneumoniae in our hospital during the recent 2 years,so as to direct rationally clinic use of drugs.MethodsThe different kinds of bacteria specimens were gathered from our hospital between Jan.2008 and Dec.2009,which were cultured,isolated and identified with ＂TIANDIREN＂microbial identification system,and the resistance sensitivity test was detected with test card corresponding to＂TIANDIREN＂microbial identification system.ResultsA total of 213 strains of K.pneumoniae were isolated,mostly from the sputum（54.46%）;there were not sensitive to Meropenem in lastest 2 years,secondly low drug-resistance were Amikacin（8.45%）and Piperacillin/Tazobactam（12.21%）.The K.pneumoniae strains were sensitive to carbapenems such as Ampicillin（100%）.The ESBLs electropositive rate was 22.54%in K.pneumoniae,and resistant rates of ESBLs producing strains were much higher than ESBLs nonproducing strains.ConclusionMeropenem is the best drugs to cure the K.pneumoniae,which can produce the ESBLs.We should take corresponding measures to control the occurrence of the nosocomial infections caused by K.pneumoniae and the produce of ESBLs strains.