454株肺炎克雷伯菌的耐药性分析

Drug Resistance of 454 Klebsiella pneumoniae Strains

目的了解医院肺炎克雷伯菌耐药情况、在科室的检出构成比及其标本来源。方法收集临床分离到的454株肺炎克雷伯菌培养鉴定,资料采用Excel 2000进行统计其在科室的分布及标本来源。结果 2008年1月~2009年6月共检出454株肺炎克雷伯菌,在内科重症监护病房检出率最高,有61株,占13.4%;其次为NICU神经外科41株,占9.0%;检出的454株肺炎克雷伯菌的标本来源,痰液300株（66.1%）,尿液50株（11.0%）,脓液29株（6.4%）;肺炎克雷伯菌对氨苄西林耐药为99.1%,其余依次为哌拉西林（41.0%）、头孢唑林（38.8%）、头孢呋辛（37.7%）、氨曲南（35.5%）。结论随着克雷伯菌耐药性增高,会给临床治疗造成很大困难,因此临床合理使用抗菌药物、严格执行消毒隔离制度,重视洗手等措施非常重要。

OBJECTIVE To understand the antibiotic resistance of Klebsiella pneumonial,its constituent ratio among departments and the source of samples from Jan 2008 to Jun 2009.METHODS A total of 454 strains of K.pneumoniae were isolated from clinic,then cultivated,identified and statistically with Excel2000.RESULTS From 454 strains,the highest rate of detection was in ICU of internal medicine（61 strains）,next was neurosurgical ICU（41strains）.Three hundred strains were from sputum,50 strains from urine and 29 strains were from pas.The rate of antibiotic resistance to ampicillin of Klebsiella was 99.1%,to piperacillin（41.0%）,to cefazolin（38.8%）,to cefuroxime（37.7%） and to aztreonam（35.5%）.CONCLUSIONS As raising up of antibiotic resistance of Klebsiella,the clinic treatment is very difficult.Rational using antibacterials,stringently executing institution of disinfection and isolation,and emphasizing hand washing are very important.