综合性医院310株肺炎克雷伯菌的临床分布及耐药性

Clinical distribution and drug resistance of 310 strains of Klebsiella pneumoniae in general hospitals

目的了解医院肺炎克雷伯菌的标本来源、科室分布及耐药情况,为临床合理用药和控制院内感染提供依据。方法从2014年1月-12月各临床送检标本中分离肺炎克雷伯菌,采用纸片扩散法对17种抗菌药物进行药敏试验,依据2014 CLSI标准判读结果,用WHONET 5.6软件对所有数据进行统计分析。结果分离出310株肺炎克雷伯菌,标本来源主要是痰、呼吸道分泌物,占48.4%;其次是中段尿,占12.9%。主要分布在重症医学科、呼吸内科和普外科,分别占22.6%、18.7%和12.9%。对哌拉西林耐药率最高,为43.9%;对亚胺培南的耐药率最低,为1.3%。结论肺炎克雷伯菌主要分离自痰、呼吸道分泌物,重症医学科检出率最高,对常用抗菌药物均产生了一定的耐药性,临床应继续做好细菌检测及其药敏试验,合理选用抗菌药物,预防医院感染的发生和多重耐药菌的产生。

Objective To investigate the specimen source, distribution and the drug resistance of Klebsiella pneumoniae, so as to provide basis for clinical use of drugs and nosocomial infection. Methods Klebsiella pneumoniae was isolated from specimens during Jan. - Dec. in 2014, drug sensitivity to 17 kinds of antibiotics was tested by K - B, and the result was interpreted by 2014 CLSI standard. WHONET 5.6 was used in the statistical analysis of all data. Results Totally 310 strains Klebsiella pneu- moniae were isolated. The detection rates were 48.4% and 12.9% respectively of the respiratory secretions and the midstream urine. The detection rates were respectively 22.6%, 18.7% and 12.9%, which were mainly from the intensive care unit, the respiratory medicine department and the department of general surgery. The highest resistance rate was 43.9% to piperaeillin, and 1.3% to imipenem, the lowest. Conclusion Klebsiella pneumoniae was mainly isolated from respiratory secretions and most from ICU, and has a certain resistance to commonly used antimierobial. We should strengthen bacteria detection and drug resistance test, reasonably use of antibiotics so as to control nosoeomial infection and the incidence of multi - drug resistance.