726株肺炎克雷伯菌的分布特征及耐药性分析

Clinical distribution and drug resistance analysis of 726 klebsiella pneumoniae

目的分析临床分离的肺炎克雷伯菌及产超广谱β-内酰胺酶(ESBLs)株的分布及药敏情况。方法采集2009年8月至2010年8月临床各科送检标本,进行肺炎克雷伯菌的分离、培养,采用Vitek-Compact系统对肺炎克雷伯菌进行鉴定和ES-BLs筛选,采用肉汤稀释法测定其对相应抗菌药物的最低抑菌浓度(MIC)值。结果共分离出肺炎克雷伯菌726株,在痰液中检出515株,ESBLs阳性216株,检出率为41.9%;各ICU病房共检出肺炎克雷伯菌407株,ESBLs阳性163株,检出率为40.0%。产ESBLs菌对亚胺培南敏感。结论肺炎克雷伯菌是常见的致病菌,及时监测产ESBLs菌的发生率与耐药趋势对指导临床用药有重要意义。

Objective To investigate the distribution and drug sensitivity instance of klebsiella pneumoniae,especially extended-spectrum β-lactamases（ESBLs）-producing strains isolated in the first affiliated hospital of Chongqing medical university.Methods Minimal inhibitory concentration（MIC）method was performed to determine the antimicrobial susceptibility.Data was analyzed by WHONET 5.5 software.Results 726 strains of K.pneumoniae were isolated,of which ESBLs strains from sputum accounted for 41.9%.407 strains were isolated from the different intensive care unit,of which ESBL strains accounted for 40.0%.The sensitive rate of ESBLs-producing K.pneumoniae to imipenem was 100%.Conclusion K.pneumoniae is the major pathogen.Detecting ESBLs-producing strains rate and their susceptibility to antibiotics is very important in guiding the clinical administration of drugs.