2006-2009年重症监护病房医院感染大肠埃希菌与肺炎克雷伯菌的耐药性分析

Drug resistance of escherichia coli and klebsiella pneumoniae causing nosocomial infection in intensive care unit during 2006-2009

目的探讨医院重症监护病房(ICU)医院感染大肠埃希菌和肺炎克雷伯菌现状及耐药特点,为预防和控制ICU的医院感染提供依据。方法收集ICU 2006年1月-2009年12月医院感染大肠埃希菌、肺炎克雷伯菌菌株,使用K-B法进行药敏试验。结果 2006-2009年ICU共检出大肠埃希菌和肺炎克雷伯菌409株,其中大肠埃希菌233株,产ESBLs大肠埃希菌61株,占26.2%,肺炎克雷伯菌176株,产ESBLs肺炎克雷伯菌38株,占21.6%;大肠埃希菌、肺炎克雷伯菌对碳青霉烯类美罗培南与亚胺培南的耐药率在所测14种抗菌药物中最低。结论经验性使用碳青霉烯类抗菌药物治疗ICU的医院感染是可行的。

OBJECTIVE To investigate nosocomial infection status and drug-resistant characteristics of Escherichia coli and Klebsiella pneumoniae in intensive care unit, to provide evidence for preventing and controlling the nosocomial infection in ICU. METHODS The strains of E. coli and K. pneumoniae causing nosocomial infection in ICU were collected from Jan 2006 to Dec 2009 and K-B method was applied to detect the susceptibility. RESULTS a total of 409 strains of E. coli and K. pneumoniae were detected in ICU from 2006 to 2009, among which 233 strains were E. coli, 61 strains were extended-spectrum beta-lactamase （ESBLs）-producing E. coli （26. 2%）, 32.5%, 176 strains were K. pneumoniae, and 38 strains were ESBLs producing K. pneumonia （21. 6%）. The resistance rates of E. coli and K. pneumoniae, including ESBLs producing strains, against carbapenems meropenem and imipenem were lowest among the 14 kinds of detected antibiotics. CONCLUSION It is feasible to empirically use earbapenems antibiotics to treat the nosocomial infection in ICU.