肿瘤患者感染肺炎克雷伯菌常见产酶的检测及耐药性分析

DETECTION AND DRUG RESISTANCE ANALYSIS OF COMMON ENZYME PRODUCING STRAINS OF KLEBSIELLA PNEUMONIAE IN TUMOR PATIENTS

目的:了解我院肿瘤患者分离的肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)和碳青霉烯酶(KPC)的情况,并分析相应菌株对常见抗菌药物的耐药性。方法:对2017年9月至2018年8月我院恶性肿瘤患者感染的306株肺炎克雷伯菌进行体外药敏试验及产ESBLs和KPC的检测,并对相应菌株的耐药性进行比较分析。结果:产ESBLs肺炎克雷伯菌检出率高达73.53%(225/306),产KPC检出率为10.46%(32/306)。产ESBLs菌株对多种抗菌药物的耐药率明显高于非产ESBLs菌株(P<0.05);产碳青霉烯酶肺炎克雷伯菌(CRKpn)对药敏试验中所有药物均呈高水平耐药,且对大部分药物的耐药率达100.00%。结论:我院肿瘤患者感染的肺炎克雷伯菌产ESBLs和KPC情况严重,相应菌株耐药率高,必须加强对医院感染的控制,规范抗菌药物的使用,防止产ESBLs菌株及CRKpn进一步增加或扩散。

Objective： To investigate the production of extended-spectrum beta-Lactamases （ESBLs） and carbapenemases （KPC） in Klebsiella pneumoniae isolated from tumor patients, and analyze the drug resistance of corresponding strains to common antibiotics. Methods： The ESBLs and KPC production of 306 strains KlebsieUa pneumoniae from tumor patients in our hospital from 2017.9 to 2018.8 were detected, and the drug resistance of corresponding swains to common antibiotics were compared by in vitro drug susceptibility. Results： The detection rate of ESBLs and KPC were 73.53% （225/306） and 10.46% （32/306） respectively. The resistance of ESBLs-producing swains to various antibiotics was significantly higher than that of non-ESBLs-producing strains （P〈0.05）. The carbapenemase- producing Klebsiella pneumoniae （CRKpn） showed high level of resistance to all the drugs tested, and the resistance rate of most of the drugs reached 100.00%. Conclusions： ESBLs and KPC produced by Klebsiella pneumoniae infected by tumor patients are serious in our hospital, and the drug resistance rate of the corresponding swains is high. It is necessary to strengthen the control of infection, standardize the application of antibiotics, and prevent further increasing or diffusion of ESBLs-producing strains and CRKpn.