综合性医院肺炎克雷伯菌的标本来源及耐药性变迁

Specimen source and drug resistance changing of Klebsiella pneumoniae in general hospital

目的分析医院肺炎克雷伯菌的标本来源及对常用抗菌药物的耐药性变迁,为临床医师合理选用抗菌药物提供依据。方法从2013年-2015年连续3年医院临床科室送检的各类标本中分离致病菌,采用法国生物梅里埃公司的VITEK 2 Compact全自动细菌鉴定药敏分析仪对所分离菌株进行细菌鉴定和药敏试验,用WHONET 5.6软件对所有数据进行统计分析。结果肺炎克雷伯菌主要分离自痰及呼吸道分泌物、中段尿和血液;2013年-2015年该菌对复方新诺明的耐药率最高,依次为53.1%、46.2%和48.6%;对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南和美罗培南的耐药率较低。结论肺炎克雷伯菌的临床标本来源没有明显变化,对各类抗菌药物呈现不同形势的耐药性变迁。应加强细菌耐药性监测,合理选用抗菌药物,防止多重耐药菌的产生。

Objective To explore the specimen source and drug resistance changing of Klebsiella pneumoniae, so as to offer proper basis for rational use of antibiotics. Methods Klebsiella pneumoniae was isolated from all kinds of specimens sent by all the departments during 2013 -2015. The identification and drug susceptibility test were conducted by French biomerieux VITEK 2 Compact fully automated bacterial identification system, and all data were statistically analyzed by WHONET 5.6. Results Kleb- siella pneumonia were ahnostly isolated from sputum, respiratory secretions, midstream urine and blood. The highest resistance rates were yearly 53.1% , 46.2% and 48.6% to chemitrim during 2013 - 2015. The resistance rates to Piperacillin/Tazobac- tam, sulperazon, imipenem and meropenem were lower. Conclusion The clinical sample of Klebsiella pneumonia has no obvi- ous change of its origin, but it shows different forms of drug resistant change to various antibiotics. So we should enhance the monitoring of drug resistance, use antibiotics rationally, so as to prevent the breeding of multi - drug resistant bacteria.