尿路感染肺炎克雷伯菌耐药分析

Analysis of drug resistance of Klebsiella pneumoniae in urinary tract infection

目的了解该院尿路感染(UTIs)肺炎克雷伯菌的分布及耐药性,为UTIs的诊治提供可靠依据。方法收集2007年1月1日至2016年12月31日该院收治的UTIs患者尿培养标本510份,常规方法培养并分离细菌,采用VITEK Compant 2全自动细菌分析仪鉴定到种,测试最小抑菌浓度,以κ-B纸片扩散法作补充,按美国临床和实验室标准化协会规定的标准进行操作及结果判断。结果 UTIs肺炎克雷伯菌中,肾脏内科分离率最高,占18.4%(94/510);耐药率以头孢菌素最高,均大于39.0%,哌拉西林/他唑巴坦和头孢哌酮/舒巴坦均小于39.0%,阿米卡星、亚胺培南和美罗培南均小于22.0%;碳青霉烯类耐药肠杆菌分离率呈上升趋势。结论肺炎克雷伯菌是医院内感染的重要病原菌,分离率呈上升趋势且耐药形势严峻,应高度重视、加强监测、做好护理及感染控制,合理使用抗菌药物。

Objective To investigat the distribution and drug resistance of Klebsiellapueultmniae in urinary tract infection of the hospital, and provide a reliable basis for the diagnosis and treatment of urinary tract infection. Methods 510 urine culture specimens of UTIs patients admitted to the hospital from January 1,2007 to December 31,2016 were collected. Routine methods were used to isolate bacteria which were identified and tested for nfininmm in hibitory concentration by VITEK 2 Compact automatic bacteria analyzer. K-B disk difl＇usion method as a supplement, and the results were judged according to CLSI standard. Results The isolating rate of Klebsiella pneuumniae was highest in nephrology department for 18.4% （94/510） ; the resistance rates of Cephalosporins were all above 39.0%, that of Piperacillin/Tazobactam and Cefoperazole/Sulbactam were lower than 39.0%,that of Amikacin,hnipenem and Meropenem were lower than 22.0%;CRE isolatingrate was rising. Conclusion Klebsiella pneuumniae is an important pathogen of nosocomial infection, whose isolatingand drug resistance rate are increasing. Paying great attention, strengthening the monitoring, nursing and infection control, as well as using antibiotic rationally are essential.