新生儿肺炎克雷伯菌肺炎53例临床特点及药敏分析

Analysis of clinical features and drug sensitivity of 53 newborn infants with klebsiella pneumoniae

目的探讨新生儿肺炎克雷伯菌肺炎的临床特点及药敏情况,了解肺炎克雷伯菌超广谱β内酰胺酶（ES-BLs）的发生率。方法收集本院2006年1月-2009年12月新生儿肺炎克雷伯菌肺炎53例痰液标本,行细菌培养、鉴定及药敏试验,并行ESBLs检测。对其临床资料进行回顾性分析。结果新生儿肺炎克雷伯菌肺炎临床特征无特异性。肺炎克雷伯菌ESBLs的检出率为39.62%。社区获得性感染与院内感染的肺炎克雷伯菌产酶率分别为30.77%,64.29%。肺炎克雷伯菌对亚胺培南敏感率100%。对头孢西丁的敏感率显著高于其他头孢类抗生素。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肺炎院内感染的肺炎克雷伯菌产ESBLs率及耐药率高于社区获得性感染。亚胺培南、头孢西丁可作为我科新生儿肺炎克雷伯菌肺炎的首选药物。

Objective To explore the clinical characteristics and drug sensitivity of newborn pneumonia of klebsiella pneumoniae,and investigate the positive rate of extended-spectrum B lactamases（ESBLs）in klebsiella pneumoniae.Methods Fifiy-three cascs of sputum samples newbom pneumonia of klebsiella pneumoniae from Jan.2006 to Dec.2009 were collected.Bacteria identification and drug sensitivity test were performed.At the same time,ESBLs were detected.Results The clinical characteristics of newborn pneumonie of klebsiella pneumoniae were nonspecial,and the positive rate of ESBLs in klebsiella pneumoniae was 39.62%.The positive rates of ESBLs in HAP were 64.29% and 30.77% in CAP（P0.05）.The klebsiella pneumoniae was 100% sensitivie to carbopenems,but resistant to commonly used penicillin and cephalosporin.Klebsiella pneumoniae had higher sensitivity to cefaxitine than to other commonly used cephalosporin.ESBLs negative strains had higher drug sensitivity than ESBLs strains.Conclusion The positive rates of ESBLs in klebsiella pneumoniae in HAP was higher than in CAP.To treat klebsiella pneumoniae in our neonate department,carbopenems and cefaxitine may be first choice.