非产超广谱β-内酰胺酶肺炎克雷伯杆菌的耐药性分析

Antibiotics resistance of non-ESBLs-producing Klebsiella pneumoniae isolates

目的了解临床分离肺炎克雷伯杆菌中非产超广谱β-内酰胺酶(ESBLs)菌株对18种常见抗菌药物的耐药性。方法 CLSI表型确证试验-纸片增强法检测非产ESBLs肺炎克雷伯菌,K-B法测定非产ESBLs肺炎克雷伯杆菌对18种常见抗菌药物的敏感性。结果非产ESBLs肺炎克雷伯杆菌株对头孢唑啉、头孢呋辛的耐药率>50.0%,对其余抗生素的耐药率均低于25.0%,对亚胺培南、美罗培南非常敏感,耐药率分别为2.3%和2.0%;痰标本的分离株对头孢唑啉、头孢呋辛的耐药率明显高于血、尿液标本分离株,差异有统计学意义(P<0.05)。结论非产ESBLs肺炎克雷伯杆菌对第一、二代头孢菌素耐药显著,对第三代头孢菌素、亚胺培南、美罗培南等抗生素比较敏感。

Objective To investigate the resistance of non-ESBLs-producing Klebsiella pneumoniae isolates to 18 kinds of antibiotics. Method Non-ESBLs producing Klebsiella pneumoniae isolates were detected by CLSI phenotypic confirmatory test, and susceptibility of these isolates to 18 kinds of antibiotics was tested by Kirby-Bauer method. Result The resistance rate of these isolates to Cefazolin and Cefoxime was higher than 50% and that to others was lower than 25.0%. The non-ESBLs producing Klebsiella pneumoniae were sensitive to Imipenem and Meropenem, and their resistance rates to Imipenem and Meropenem were 2.3% and 2.0%, respectively. The resistance rate of the isolates from sputum samples to Cefazolin and Cefoxime was significantly higher than those from blood, urine （P 〈 0.05）. Conclusion Most isolates of non-ESBLs-producing Klebsiella pneumoniae are resistant to the first and second generation cephalosporins, while susceptible to meropenem, the third generation cephalosporins and other antibiotics.