肺炎克雷伯菌对碳青霉烯类抗菌药物的耐药性变迁研究

Study on variation of carbapenems resistance of Klebsiella pneumoniae

目的探讨2007-2009年肺炎克雷伯菌(KPN)对碳青霉烯类抗菌药物的耐药性变迁,应用国内外相关文献进行总结,说明合理使用碳青霉烯类药物的重要性。方法统计分析3年KPN的耐药性,采用M-H琼脂稀释法测定亚胺培南和美罗培南对细菌的最低抑菌浓度(MIC),了解其变迁趋势。结果 2007-2009年KPN分离率逐年上升,对亚胺培南的耐药率从2007年的1.4%升至2009年的4.7%,对美罗培南的耐药率从2007年的0.9%升至2009年的2.0%,3年中KPN对这2种抗菌药物的累积MIC值持续上升。结论 KPN耐药菌株的不断增加,给临床治疗带来了很大困难,加强对该菌感染治疗的合理用药,降低耐药率,减少医院感染的潜在危险,是检验科和临床医师应高度重视的问题。

OBJECTIVE To study on variation of carbapenems resistance of Klebsiella pneumoniae from 2007 to 2009,to carry on the summary and the summary by applying the domestic and foreign related literature,so as to explain the importance of reasonable use of carbapenems antibiotics.METHODS Statistical analysis of the variation of the Carbapenems resistance of K.pneumoniae was performed,and the minimum inhibitory concentration（MIC） of imipenem and meropenem of K.pneumoniae were determined by the M-H agar dilution method.Then we understood the change trend of Carbapenems resistance.RESULTS The isolated rate of K.pneumoniae was increased year after year from 2007 to 2009.The resistance of imipenem increased from 1.4% in 2007 to 4.7% in 2009,and,for meropenem was 0.9% in 2007 to 2% in 2009.The accumulation MIC value of the two carbapenems of K.pneumoniae in three years were higher.CONCLUSION The increasing drug-resistant isolates of K.pneumoniae bring great difficulty to the clinical treatment,so clinical laboratory and clinicians should pay attention to the reasonable use of antibiotics to reduce the drug resistance rate and the risk factors of nosocomial infections.