2012年肺炎克雷伯菌的临床分布及耐药性分析

Clinical distribution and antibiotic resistance of Klebsiella pneumoniae in 2012

目的了解我院2012年肺炎克雷伯菌感染的临床分布及耐药情况,为临床合理用药提供参考依据。方法收集2012年1月至2012年12月医院住院患者送检的标本进行分离培养,菌株鉴定采用全自动细菌鉴定仪,采用纸片扩散法(K-B法)测定25种抗菌药物的敏感情况,用WHONET 5.4软件进行分析。产ESBLs检测采用双纸片增效法,对其分布及抗菌药使用进行分析。结果分离出294株肺炎克雷伯菌,产ESBLs检出62株(21.1%),痰液中检出率最高(67.35%),主要分离自ICU(19.05%),产ESBLs菌株对多数抗菌药物的耐药率明显高于非产ESBLs菌株(P<0.01)。结论肺炎克雷伯菌,尤其是产ESBLs肺炎克雷伯菌对抗菌药物具有一定程度的耐药性,应根据药敏结果结合临床感染情况合理选用抗菌药物,有效控制耐药菌的产生。

Objective To investigate the distribution and antibiotic resistance of Klebsiella pneumoniae （KPN） isolated from our hospital and offer suggestions for clinic. Methods The specimens submitted from the hospitalized patients were isolated and cultured from January to December 2012, the bacterial identification were performed by adopting the automatic microorganism ana- lyzing system. The antibiotic susceptibihties to 25 kinds of antibiotics were tested by K-B method and analyzed by Whonet soft- ware. Double disk synergy test was adopted in the strains with extended ESBLs, the distribution and the use of antibiotics were analyzed. Results There were 294 strains of K. pneumoniae isolated among which there were 62 ESBLs producing strains with the detection rate of 21.1% in the 294 KPN. The strains were mainly isolated from the sputum, accounting for 67.35%. The isolates mainly distributed in ICU （19.05%）. The drug resistance rate of ESBLs producing strains was significantly higher than that of non- ESBLs-producing strains （P〈0.01）. Conclusion KPN isolates, ESBLs producing strains in particularly, show resistance to the an- tibiotics in the investigation. The drugs should be chosen reasonably according to their antibiotic susceptibility results so as to ef- fectively control the drug resistant strains.