2499例肺炎克雷伯菌临床分布及耐药性分析

Analysis of clinic distribution and antibiotic resistance of 2499 isolates of Klebsiella pneumoniae

目的分析肺炎克雷伯菌耐药性趋势,指导临床合理用药。方法对医院2 499例临床送验标本分离出的肺炎克雷伯菌耐药性进行统计分析。结果标本来源以痰液、尿液和血液居前3位,分别占比52.78%、12.28%、10.04%。肺炎克雷伯菌对青霉素类、头孢类抗菌药物耐药率高于80%;对碳青霉烯类抗菌药物亚胺培南耐药率有增长趋势;对替甲环素和厄他培南均高度敏感。2 499例多重耐药的肺炎克雷伯菌检出率分别为24.45%,多重耐药的肺炎克雷伯菌检出率呈上升趋势。结论针对肺炎克雷伯菌耐药性变迁,及时采取抗菌药物预警指导,合理使用抗菌药物,有效控制繁殖耐药菌产生,降低耐药率。

Objective To investigate the trend of the clinic distribution and antibiotic resistance of Klebsiella pneumoniae,and to guide clinical application of antibiotics. Methods To analyze the antibiotic resistance of 2 499 isolates of Klbsiella pneumoniae from clinical samples collected in our hospital during the period of 2013- 2015.Results The Klebsiella pneumonia-positive specimens were mostly derived from sputum（ 52. 7%）, urine（ 12. 28%）,and blood（ 10. 04%）. The rates of resistance to cephalosporins and penicillins were above 80%. As for carbapenems,clinical isolates of Klebsiella pneumoniae are sensitive for tigecycline and ertapenem,while the resistance rate for imipenem is incresing,The rates of multidrug resistance in 2 499 strains isolated during 2013-2015 is 24. 45% which is higher than records. Conclusions Accordding to the changing profile of drug resistance of Klebsiella pneumoniae,effective control of production of resistant bacteria and reduces the rate of drug resistance need early warning guidance of antimicrobial agents in time and rationally application.