2013年昆明医科大学第一附属医院肺炎克雷伯菌耐药性监测及分析

Surveillance and analysis of drug resistance of Klebsiella pneumoniae in the First Affiliated Hospital of Kunming Medical University in 2013

目的了解昆明医科大学第一附属医院2013年肺炎克雷伯菌的分离及耐药情况,为临床合理选用抗菌药物和预防院内感染提供依据。方法回顾性分析该院2013年1-12月临床标本中分离的568株肺炎克雷伯菌,采用VITEK2型全自动细菌分析仪进行鉴定和药敏试验。按美国临床实验室标准协会(Clinical and Laboratory Standards Institute,CLSI)2012年版标准判断结果,应用WHONET 5.6软件进行统计和分析结果。结果 2013年该院临床送检标本中分离到肺炎克雷伯菌568株,其中碳青霉烯类耐药的肺炎克雷伯菌96株检出率为16.9%,肺炎克雷伯菌对亚胺培南、厄他培南和美洛培南的耐药率分别为16.9%、19.1%和16.8%;产ESBLs的肺炎克雷伯菌有189株检出率为33.3%。结论 2013年度该院分离的肺炎克雷伯菌耐药现象较为严重,开展细菌耐药性监测及分析,对指导临床合理使用抗生素,降低医院感染率和控制细菌耐药性有重要意义。

Objective To investigate the isolation and drug resistance status of Klebsiella pneumonia from patients in the First Affiliated Hospital of Kunming Medical University in 2013 and guide the rational use of antibiotics and prevent the nosocomial infection. Methods The bacteria strains isolated from clinics were collected and retrospectively analyzed. Identification and drug susceptibility test were performed by VITEK2 automatic analysis system and the results were analyzed according to the standard published by the Clinical and Laboratory Standards Institute （CLSI） using WHONET 5.6 software. Results A total of 568 clinical isolates of K. pneumoniae were analyzed in 2013. 96 K. pneumoniae strains resistance to Carbapenems were detected （detection rate of 16.9%）. The resistance rates to Imipenem,Meropenem and Ertapenem of K. Pneumoniae isolates were 16.9%, 16.8%and 19.1%respectiveiy. 189 K. pneumoniae strains ESBLs-producing were detected （detection rate of 33.3%）. Conclusion the drug resistance phenomenon of Klebsiella pneumoniae isolatexd from our hospital is more serious. Therefore, we should carry out the surveillance of bacterial resistance. It has important significance for guiding clinical rational use of antibiotics, reducing hospital infection rate and controlling bacterial drug resistance.