肺炎克雷伯菌耐药性趋势及特征性分析

Analysis of characteristics and trend of drug resistance of Kebsiella pneumoniae

目的:了解不同感染部位分离的肺炎克雷伯菌耐药性,指导临床合理用药。方法:对2010年1月至2011年9月不同感染部位分离的260株肺炎克雷伯菌,去除部位相同的近期重复送检标本,采用ATB EXPRESSION型半自动微生物分析仪检测,超光谱β-内酰胺酶(ESBLs)按临床和实验室标准协会推荐的确诊试验检测。结果:2011年分离的肺炎克雷伯菌的ESBLs检出率及对环丙沙星、头孢噻肟、头孢呋辛、亚胺培南、美洛培南、哌拉西林、替卡西林/克拉维酸的耐药性均高于2010年分离株(P<0.05～P<0.01);创面感染分离的肺炎克雷伯菌对头孢噻肟、哌拉西林/他唑巴坦的耐药率均低于非创面感染分离株(P<0.05);老年组与青壮年组的ESBLs检出率及对20种抗菌药物耐药率差异均无统计学意义(P>0.05)。结论:感染部位不同,其耐药性特点也不同,临床医生在抗感染治疗过程中,应根据不同特点合理使用抗菌药物,以期延缓细菌耐药性的产生。

Objective：To investigate the drug resistance of Kebsiella pneumoniae isolated from different infection positions and guide the clinical rational medication.Methods：From Jan.2010 to Sep.2011,the extended-sprctrum β-lactamases（ESBLs） of 260 strains of Klebsiella pneumoniae isolated from different infection positions were detected using ATB EXPRESSION semi-automatic microorganism analyzer according to the standard of the clinical and Laboratory Standards Association recommending diagnostic tests.Results：The detection rates of ESBLs and drug resistance to ciprofloxacin,cefotaxime,cefuroxime,imipenem,meropenem,piperacillin and ticarcillin/clavulanate of Klebsiella pneumoniae isolated from 2011 year were higher than that from 2010 year（P0.05 to P0.01）.The drug resistance to cefotaxime,piperacillin and tazobactam of Klebsiella pneumoniae isolated from infection position was lower than that from non-infection position（P0.05）.There were not significant difference between the detection rate of ESBLs and drug resistance to 20 kinds of antibiotics in the older group and young adults group（P0.05）.Conclusions：The drug resistance has different characteristics in different infection postions.The antibacterial drug should be reasonably used according to different characteristics in clinic,which can delay the emergence of drug resistance of bacteria.