152株克雷伯杆菌对常用抗菌药物敏感性的体外研究

Study on Susceptibility of 152 Strain of Klebsiella

为明确克雷伯杆菌对临床常用抗菌药物的敏感性， 收集了１９９６年度武汉市１３ 家大中型医院住院免疫低下患者体内分离的克雷伯杆菌， 并用琼脂板稀释法测定１６ 种抗菌药物的最低抑菌浓度。结果共得细菌１５２ 株， 以肺炎克雷伯杆菌为主 （１２８ 株）， 尚有臭鼻克雷伯杆菌 （１３株）、催产克雷伯杆菌 （９ 株）、鼻硬结克雷伯杆菌 （２ 株）。药敏测定表明： β－内酰胺类中除头孢他啶、依米配南的ＭＩＣ９０≤１６ μｇ／ｍ ｌ， 其它对克雷伯杆菌的ＭＩＣ９０ 均较高， 但阿米卡星、环丙沙星的ＭＩＣ９０仅为８ 和１ μｇ／ｍ ｌ。臭鼻和催产克雷伯杆菌对部分抗菌药物的耐药性高于肺炎克雷伯杆菌。比较不同部位分离的肺炎克雷伯杆菌药敏，结果表明：非呼吸道分离的肺炎克雷伯杆菌对药物的敏感性总体上低于呼吸道分离的菌株。

To understand the resistance and susceptibility of Klebsiella spp to common antimicrobial agents, all of Klebsiella spp from the immunocompromised hospitalized patients in 13 hospitals in Wuhan were collected during 1996, and their MIC for 16 antimicrobial agents were assayed by agar dilution plate method. 152 strain of Klebsiella, which consisted of K. pneumoniae (128),K. ozaenae (13) and K. oxytoca (9), were obtained. As a result of drug sensitive test, a low MIC90 (≤16 μg/ml) was discovered for CAZ, IPM, AMK and CIP, but other antimicrobial agents showed a high MIC90 value. The resistance of K. ozaenae and K. oxytoca to some agents was higher than that of K pneumoniae. This study also suggested that K. pneumoniae isolated from the respiratory tracts are less resistant than that from the other lesions in principle.