肺炎克雷伯菌的分布及耐药性分析

Distribution and drug resistance analysis of Klebsiella pneumonias

目的了解医院肺炎克雷伯菌的分布及耐药特点,为临床治疗相关感染提供依据。方法对本院2017年1月-12月227株肺炎克雷伯菌(KPN)的分布及耐药情况进行回顾性分析;使用西门子MicroScan walkAway-96细菌鉴定及药敏分析系统进行细菌鉴定和药敏试验;按照美国临床实验室标准化委员会(NCCLSI)2015年标准进行判读。结果 227株肺炎克雷伯菌主要分布在痰液和尿液中,分别占68.7%和16.7%;分离率前3位的科室分别是重症医学科、呼吸科和神经科;分别对总227株KPN、61株ICU分离株和54株神经科分离株的耐药情况进行统计分析,ICU分离株除了对替加环素和阿米卡星的耐药率较低外,对其他18种抗菌药物的耐药率均超过了50%。结论肺炎克雷伯菌是呼吸道和泌尿道感染的常见病原菌;其耐药形势不容乐观,ICU是耐药菌的重灾区,临床应加强抗菌药物的合理应用,减缓耐药菌株的出现。

Objective To understand the distribution and the drug resistance of K.pneumonias,so as to provide basis for the clinical treatment of related infection.Methods The distribution and drug resistance of 227 K.pneumonias in our hospital from January to December 2017 were retrospectively analyzed;bacterial identification and drug sensitivity were conducted by SIEMENS MicroScan walkAway-96 bacterial identification and drug sensitivity analysis system;and the results were interpreted according to the standard of National Committee for Clinical Laboratory Standard Institution(NCCLSI)in 2015.Results The 227 K.pneumonias were mainly observed in sputum and urine,accounting for 68.7% and 16.7% respectively;the top three departments with the highest separation rate were ICU,the Department of Respiration and the Neurology Department,respectively.The total resistance of 227 strains,61 ICU strains and 54 neurologic strains were statistically analyzed respectively.The resistance rates of ICU isolates to the other 18 antimicrobial agents were over 50% except for the low drug resistance rate to tegafloxin and Amikacin.Conclusion K.pneumonias are the common pathogen in respiratory tract and urinary tract infection;its drug resistance situation is not optimistic.ICU is the heavy disaster area of drug resistant bacteria.The rational application of antibiotics should be strengthened in clinical practice to slow down the emergence of drug-resistant strains.