肺炎克雷伯菌的耐药性分析及分布

Analysis of drug resistance and distribution of Klebsiella pneumonia

目的及时了解院内分离肺炎克雷伯菌的耐药性及标本分布,为提高临床经验用药提供依据。方法用WHONET5.6对2015年1月1日-2015年3月31日间临床分离的136株肺炎克雷伯菌对临床常用的19种抗菌药物的耐药性及分布进行分析。结果分离的136株肺炎克雷伯菌对头孢唑啉、头孢呋辛、头孢噻肟、复方新诺明、头孢吡肟、氨曲南、庆大霉素、头孢他啶、阿莫西林/克拉维酸、妥布霉素、环丙沙星、头孢西丁、左旋氧氟沙星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星、厄他培南、美罗培南和亚胺培南的耐药率分别为41.9%(57/136)、39.7%(54/136)、36.0%(49/136)、31.6%(43/136)、27.9%(38/136)、26.5%(36/136)、24.3%(33/136)、21.3%(29/136)、18.4%(25/136)、18.4%(25/136)、17.6%(24/136)、16.2%(22/136)、12.5%(17/136)、9.6%(13/136)、7.4%(10/136)、3.7%(5/136)、2.9%(4/136)、2.9%(4/136)和2.9%(4/136)。70.6%(96/136)的标本来源于痰液,16.2%(22/136)的标本来源于尿液。20.6%(28/136)的标本分布在儿内科病房,11.8%(16/136)的标本分布在肿瘤微创科病房。结论院内分离的肺炎克雷伯菌主要引起呼吸道感染,对临床常用的抗菌药物耐药率相差较大,临床应及时了解本院常见菌的耐药性及分布,以提高经验用药的准确率。

Objective： To investigate the drug-resistance and distribution of Klebsiella pneumoniae isolated timely in clinical use so as to provide evidence for improving the clinical experience of drug use. Methods： 136 stains of Klebsiella pneumoniae were collected from January 1,2015 to March 31,2015,whose drug-resistance to 19 antibacterial and clinical distribution was analyzed by WHONET 5. 6. Results： Drug-resistance rates of 136 stains of Klebsiella pneumonia to cefazolin,cefuroxime,cefotaxime,cotrimoxazole,cefepime,aztreonam,gentamicin,ceftazidime,amoxicillin / clavulanic acid,tobramycin,ciprofloxacin,cefoxitin,levofloxacin,cefoperazone / sulbactam,piperacillin / tazobactam,amikacin,ertapenem,meropenem and imipenem were 41. 9%（ 57 /136）,39. 7%（ 54 /136）,36. 0%（ 49 /136）,31. 6%（ 43 /136）,27. 9%（ 38 /136）,26. 5%（ 36 /136）,24. 3%（ 33 /136）,21. 3%（ 29 /136）,18. 4%（ 25 /136）,18. 4%（ 25 /136）,17. 6%（ 24 /136）,16. 2%（ 22 /136）,12. 5%（ 17 /136）,9. 6%（ 13 /136）,7. 4%（ 10 /136）,3. 7%（ 5 /136）,2. 9%（ 4 /136）,2. 9%（ 4 /136） and 2. 9%（ 4 /136） respectively. 70. 6%（ 96 /136） of Klebsiella pneumoniae was collected from sputum specimens,and 16. 2%（ 22 /136） from urine specimens. 20. 6%（ 28 /136） of strains was distributed in Pediatric ward and11. 8%（ 16 /136） was distributed in Oncology Minimally Invasive Department. Conclusion： Klebsiella pneumoniae separated in clinic mainly caused respiratory infections,and the drug-resistance rates to antibacterial drug that are commonly used in clinic vary widely. Thus,timely understanding of the drug resistance and distribution of the common bacteria isolated in our hospital can improve the accuracy of empirical medication.