慢性阻塞性肺疾病患者呼吸道感染肺炎克雷伯菌的耐药性研究

目的探讨不同级别慢性阻塞性肺疾病（COPD）患者和不同年龄段患者呼吸道感染肺炎克雷伯菌（KP）的耐药情况。方法使用自动微生物分析仪鉴定KP，利用琼脂稀释法检测抗菌药物敏感性，采用Pearson卡方检验、Yates卡方检验和确切概率法分析相关数据。结果KP主要来自于Ⅲ级、Ⅳ级COPD患者和不低于60岁患者。环丙沙星、头孢他啶在Ⅳ级患者中的耐药率明显高于I级、Ⅱ级患者（P〈0．05），左氧氟沙星在Ⅲ级患者中的耐药率明显高于Ⅱ级患者（P〈0．05），头孢噻肟在I级患者中的耐药率明显低于Ⅲ级、Ⅳ级患者（P〈0．05），而氨曲南在Ⅳ级患者中的耐药率明显高于其他级患者（P〈0．05）。环丙沙星、左氧氟沙星、头孢他啶、头孢噻肟和氨曲南在不低于60岁患者中的耐药率明显高于40～59岁患者的耐药率（P〈0．05）。结论KP的耐药形势非常严峻，特别是在Ⅲ级、Ⅳ级患者和不低于60岁患者中。

Objective Investigate the condition of drug resistance to klebsiella pneumoniae （KP） in all kind severity grade chronic obstructive pulmonary disease （COPD） and patients of all ages.Methods Automated microbiology analyzer was used by identifica- tion of the bacteria,the drug sensitivity was performed by using agar dilution method,Pearson chi square test,Yates chi square lest and exact propability were used by analyze the data.Results KP mainly from the Ⅲ, Ⅳ grade COPD patients and I〉60 patients.The resistance rate of IV grade COPD patients significantly higher than the Ⅱ , Ⅱ grade COPD patients to ciprofloxacin and ceftazidime （P〈 0.05）.The resistance rate of m grade COPD patients significantly higher than IT grade COPD patients to levofloxacin （P〈0.05）.The resistance rate of I grade COPD patients significantly lower than them, IVgrade COPD patients to cefotaxime,and the resistance rate of aztreonam in the IVgrade COPD patients was the highest（P〈0.O5）.The resistance rate of /〉60 patients significantly higher than 40-59 year patients to ciprofloxaein, levofloxacin,cefiazidime,cefotaxime and aztreonam.Conclusion The resistance situation is serious to KP,especially in the Ⅲ ,ivgrade COPD patients and 1〉60 year patients.