来源于患儿下呼吸道肺炎克雷伯菌的ESBLs检测及耐药性研究

Study on the ESBLs detection and resistance of klebsiella pneumoniae which come from lower respiratory tract of children

目的探讨来源于患儿下呼吸道肺炎克雷伯菌（KP）的产ESBLs情况及耐药性。方法 104株患儿下呼吸道KP收集在2013年7月~2015年7月期间。KP的鉴定采用全自动微生物分析仪;ESBLs的检测采用ESBLs检测试剂盒、药物敏感性试验采用琼脂稀释法;数据分析采用x^2检验。结果氨苄西林的耐药率高达100.00%（104株）;ESBLs的检出率为39.42%（41株）;头孢唑啉、头孢西丁、头孢呋辛、头孢他啶、头孢噻肟、氨曲南、左氧氟沙星在ESBLs阳性组的耐药率明显高于阴性组（P〈0.05）;头孢唑啉、头孢他啶、头孢噻肟、头孢吡肟、左氧氟沙星在儿科重症监护病房的耐药率明显高于普通儿科病房和新生儿病房（P〈0.05）。结论来源于患儿下呼吸道KP的耐药形势严峻,特别是产ESBLs和儿科重症监护病房的KP。

Objective To Investigate the extended spectrum β-lactamase（ESBLs） detection and resistance of klebsiella pneumoniae（KP） which come from lower respiratory tract of children. Methods No repeat 104 strains of KP were separated from July 2013 to July 2015. Identification of the bacteria was used by automated microbiology analyzer. The drug sensitivity was used by agar dilution method.ESBLs-producing strains was confirmed by ESBLs detection kit,and analyticed the data was used by chi square test. Results The resistance rate of Ampicillin was 100.00%.The detection rate of ESBLs was 39.42%（41 strains）.The resistance rate of Cephazolin and so on in the positive group of ESBLs were significantly higher than negative group of ESBLs（P 〈0.05）.The resistance rate of Ceftazidime and so on in the pediatric intensive care unit were significantly higher than general pediatric ward and newborn nursery（P 〈0.05）. Conclusion Resistance situation of KP which come from lower respiratory tract of children is grim,especially the ESBLs-producing KP and pediatric intensive care unit KP are more.