儿科多重耐药肺炎克雷伯菌的检测及其耐药性分析

Analysis of detection and drug resistance of multidrug-resistant Klebsiella pneumoniae in pediatric patients

目的观察我院儿科住院患者多重耐药肺炎克雷伯菌的临床分布特点及其耐药性,为儿科脓毒症感染的治疗提供诊治依据。方法收集2016年1月至2018年1月我院儿科住院患者的各类送检标本,行细菌鉴定和药敏分析。结果共检出肺炎克雷伯菌744株,其中检出最多的是血液标本,其次是痰液和尿液标本,分别占48.52%、31.59%、10.49%;患儿科室分布以NICU和PICU为主,分别占63.04%、20.83%。多重耐药肺炎克雷伯菌对氨苄西林、头孢呋辛、头孢唑啉、头孢噻肟、头孢曲松、头孢吡肟的耐药严重,而对哌拉西林/他唑巴坦、碳青霉烯类药物、阿米卡星均敏感。结论儿科住院患者对肺炎克雷伯菌的耐药率均较高,尤其是ICU患儿,医生应该加强对抗生素的管理,合理、规范地使用,预防肺炎克雷伯菌的医院感染的暴发。

Objective To study the clinical distribation characteristics and drug resistance of multidrug-resistant Klebsiella pneumoniae in pediatric inpatients of our hospital, in order to provide the diagnosis and treatment basis for the treatment of pediatric sepsis infection. Methods The samples were collected from hospitalized pediatric patients in our hospital from January 2016 to January 2018. The bacterial identification was performed and drug susceptibility was analyzed. Results A total of 744 strains of multidrug-resistant Klebsiella pneumoniae were identified,o f which the most common were whole blood samples,followed by sputum and urine specimens,which accounted for 48. 52%,31. 59% and 10. 49%, respectively. The bacteria were mainly distributed in NICU and PICU,which accounted for63. 04% and 20. 83%, respectively. Multidrug-resistant Klebsiella pneumoniae had strong resistance to ampicillin, cefuroxime,cefazolin, cefotaxime, ceftriaxone and cefepime; however, it was sensitive to piperacillin/tazobactam, carbapenem antibiotics and amikacin. Conclusion The multidrug-resistant Klebsiella pneumoniae in pediatric patients are all highly resistant to the commonly-used antibiotics, especially in ICU. So doctors should strengthen the management of antibiotics. It should be rational and standardized to use antibiotics in order to prevent the outbreak of nosocomial infection of Klebsiella pneumoniae.