耐碳青霉烯类药物肺炎克雷伯菌和鲍曼不动杆菌对替加环素的敏感性分析

The Sensitivity of Carbapenem-Resistant Klebsiella Pneumoniae and Acinetobacter Baumannii to Tigecycline

目的 分析耐碳青霉烯类药物肺炎克雷伯菌和鲍曼不动杆菌对替加环素的敏感性,为临床控制耐碳青霉烯类药物病菌繁殖提供理论依据。方法 收集2016年12月~2017年12月本院住院患者送检标本中分离出来的耐碳青霉烯类药物肺炎克雷伯菌112株和耐碳青霉烯类药物鲍曼不动杆菌98株,比较耐碳青霉烯类药物肺炎克雷伯菌和鲍曼不动杆菌对各类抗菌药物的耐药性差异。结果 耐碳青霉烯类药物的肺炎克雷伯菌和鲍曼不动杆菌几乎对所有抗菌类药物都有较强的耐药性;耐碳青霉烯类药物肺炎克雷伯菌对替加霉素的敏感菌数为97株,占86.61%,而耐碳青霉烯类药物鲍曼不动杆菌对替加霉素的敏感菌数为68株,占69.39%,替加环素对肺炎克雷伯菌的敏感性明显优于鲍曼不动杆菌,差异有统计学意义(χ~2=14.034,P=0.001);当MIC为4 mg/L时耐碳青霉烯类肺炎克雷伯菌的敏感率为100.00%,而碳青霉烯类鲍曼不动杆菌敏感率为71.21%,替加环素对两类菌体外敏感率分布差异有统计学意义(χ~2=18.488,P=0.002)。结论 耐碳青霉烯类药物肺炎克雷伯菌对替加环素的敏感性明显高于耐碳青霉烯类药物鲍曼不动杆菌,所以临床上采用替加环素可以有效控制耐碳青霉烯类肺炎克雷伯菌。

Objective To analyze the sensitivity of carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii to tigecycline so as to provide an evidence for control of carbapenem-resistant bacteria neumonia.Methods One hundred and twelve specimens of carbapenem-resistant K.pneumoniae and 98 specimens of A.baumannii were collected in the hospital from 2016 to 2017.All of the isolates exhibited a broad spectrum antibiotic resistance.Results Ninety of 112 isolates (86.61%) of K.pneumoniae showed their sensitivity to tigecycline whereas 68 of 98 (69.39%) isolates of A.baumannii showed the sensitivity to tigecycline,demonstrating a higher sensitivity of K.pneumoniae to tigecycline than that of A.baumannii (P=0.001).All strains of carbapenem-resistant K.pneumoniae were found to be sensitive to tigecycline at MIC 4 mg/L when compared with A.baumannii that showed 71.21 percent of sensitivity(χ~2=18.488,P=0.002)Conclusion Carbapenem-resistant K.pneumoniae has a higher antibiotic sensitivity to tigecycline than A.baumannii,suggesting a choice of use of tigecycline in control of pneumonia.