儿童医院重症监护室分离肺炎克雷伯菌株的耐药性分析

Analysis the Antimicrobial Resistance of Klebsiella Pneumoniae in Children's Intensive Care Unit

目的了解儿童医院重症监护室(ICU)分离肺炎克雷伯菌及耐药情况,为临床治疗及ICU感染的控制提供依据。方法对儿童医院2007年4月至2008年5月临床检出菌,用法国生物梅里埃系统鉴定及药敏分析,并用双纸片法对ICU分离的肺炎克雷伯菌进行超广谱β-内酰胺酶(extend-spectrumβ-lactamases,ESBLs)检测,同时对产ESBLs及非产ESBLs菌株进行耐药性分析。结果 ICU病房总共检出肺炎克雷伯菌108株,其中检出ESBLs阳性菌株73株,产酶率为67.59%。对12种抗生素进行药敏试验,耐药率最低的是亚胺培南,其次是环丙沙星。结论 ICU病房等免疫力低下的患者是肺炎克雷伯菌的易感人群,且以呼吸道感染为主。治疗感染产ESBLs肺炎克雷伯菌的有效药物为抗生素与酶抑制的复方制剂和亚胺培南。

Objective To know the antimicrobial resistance of klebsiella pneumoniae in intensive care unit（ICU）fot clinical application of antibiotics.Methods The system was used to indentify the bacteria,which were isolated from April,2007 to May,2008 in our hospital.A double disk test was used to detect ESBLs in the isolated klebsiella pneumoniae from ICU.Then we analysed the drug resistance of klebsiella pneumoniae of different status of producing ESBLs.Results 108 klebsiella pneumoniae were isolated from ICU,the percentage of producing ESBLs was 67.59%.The resistant rate of IPM was the lowest in the 12 antibiotics,CIP was the later.The rate of drug resistance of the ESBLs producers was significant higher than that of ESBLs nonproducers.Conclusion The patients in ICU were easy to infect klebsiella pneumoniae.IPM and the compound preparations of antibiotics and enzyme inhibitor are the effective drugs to treat the patients who infect ESBLs klebsiella pneumoniae.