肺炎克雷伯菌临床分布特点与耐药性分析

Analysis of clinical distribution and drug resistance of Klebsiella pneumoniae

目的探讨医院肺炎克雷伯菌的临床分布及耐药性,为临床用药提供参考依据。方法选取医院2011年3月-2013年2月临床分离出的肺炎克雷伯菌960株,分析其科室分布及标本来源,并进行临床常用抗菌药物耐药性分析,用Whonet5.4软件进行统计分析。结果分离的960株肺炎克雷伯菌主要来源于重症医学科、神经外科和呼吸内科,分别占24.06%、21.04%和13.23%;主要标本来源于痰液和尿液,分别占69.17%和11.77%;肺炎克雷伯菌对哌拉西林、氨苄西林、头孢呋辛和氨苄西林/舒巴坦耐药率较高,分别为98.44%、96.46%、27.60%和25.52%,对阿米卡星、亚胺培南、厄他培南和美罗培南的耐药率较低,分别为4.27%、3.75%、2.19%和1.56%。结论肺炎克雷伯菌对常用头孢类药物具有较高的耐药性,应通过药敏试验加强对其耐药性监测,指导临床合理用药。

OBJECTIVE To study the clinical distribution and antibiotic‐resistance on K lebsiella pneumoniae in our hospital ,so as to provide the reference for the clinical diagnosis and reasonable medication .METHODS Totally 960 strains of K .pneumoniae were isolated clinically in our hospital from Mar .2011 to Feb .2013 ,and the clinical distribution and specimen sources were analyzed .The identification was conducted with automatic micro‐bacteria verification analyzer ,and the drug susceptibility test were carried out by K‐B method and statistical analysis was done with Whonet 5 .4 software .RESULTS The K .pneumoniae were mainly isolated from sputum （69 .17% ） and urine （11 .77% ） in department of ICU （24 .06% ） ,neurosurgery （21 .04% ） and respiratory medicine （13 .23% ） . The resistance rate of K .pneumoniae to piperacillin ,ampicillin ,cefuroxime and ampicillin/sulbactam were high , namely 98 .44% ,96 .46% ,27 .60% and 25 .52% respectively .T he drug resistance rate of them to amikacin ,imi‐penem ,meropenem and ertapenem were relatively low ,namely 4 .27% ,3 .75% ,2 .19% and 1 .56% relatively . CONCLUSION The results suggest that K .pneumoniae was resistant to common antibiotics and it is necessary to rationally use antibiotic agents and constantly and effectively conduct drug resistance surveillance .