临床分离肺炎克雷伯菌对碳青霉烯类药物的耐药性研究

STUDY ON CARBAPENEM RESISTANCE OF CLINICALLY ISOLATED KLEBSIELLA PNEUMONIAE

目的临床分离肺炎克雷伯菌对碳青霉烯类药物的耐药性变迁,为临床合理使用抗菌药物提供参考。方法通过临床标本细菌分离鉴定和药敏试验方法,对某医院2009-2012年临床送检标本病原学检验结果进行调查与分析。结果该医院连续4年从临床送检标本中共分离出肺炎克雷伯菌1 384株。2009-2012年每年分离的肺炎克雷伯菌对亚胺培南的敏感率分别为100%、99.1%、98.8%和92.8%,呈逐年下降趋势。检出10株耐碳青霉烯类药物的肺炎克雷伯菌对阿米卡星敏感率为90%,但对亚胺培南和庆大霉素敏感率分别为20%和10%,对其他类抗菌药物全部耐药。结论耐碳青霉烯类药物的肺炎克雷伯菌对多数种类抗菌药物敏感性逐年下降,易引起产酶克隆株播散流行。

Objective To analyze the changes of Carbapenem resistance of Klebsiella pneumoniae isolated from clinic so as to give some reference to clinical rational use of antibiotics. Methods The methods of bacterial isolation and identification and drug susceptibility test were used to investigate and analyze the results of pathogenic detection from clinical samples in a hospital during year 2009-2012. Results There were 1 384 strains of Klebsiella pneumoniae isolated from clinic samples continuously for 4 years in this hospital. Sensitive rate to Imipenem of Klebsiella pneumoniae isolated from year 2009-2012 were 100%,99. 1%,98. 8% and 92. 8% respectively with a declining trend. The sensitive rate to Amikacin of 10 strains of Carbapenem-resistant was the highest（ 90%）,followed by Imipenem（ 20%） and Gentamicin（ 10%）,and the rest were 0. Conclusion The susceptibility of Carbapenem-resistant Klebsiella pneumoniae to many kinds of antibiotics is decreased yearly and can easily cause the epidemic of Carbapenemases strains in hospital.