肺炎克雷伯菌医院感染现状及耐药性分析(1)
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【摘要】目的：了解我院2010年肺炎克雷伯菌对常用抗菌药物的耐药现状及标本分布，为临床治疗提供依据。方法：采用回顾性方法统计分析448株肺炎克雷伯菌的标本来源、感染科室分布及耐药情况。结果：临床标本中肺炎克雷伯菌除对碳青霉烯类亚胺培南、美洛培南以及含有β-内酰胺酶抑制剂的复方制剂头孢哌酮/舒巴坦、哌拉西林/他唑巴坦高度敏感外(敏感率高于96.0%)，对其他各类常用抗菌药物均表现不同程度的耐药现象。如对青霉素类氨苄西林和1～3代头孢菌素头孢唑林、头孢呋辛、头孢曲松、头孢噻肟普遍存在较高的耐药性，其耐药率均在50.0%以上；氨基糖苷类阿米卡星、异帕米星和喹诺酮类左氧氟沙星、环丙沙星的耐药率稍低，大多在20.0%～30.0%之间。结论：该临床分离的肺炎克雷伯菌耐药严重，且呈多重耐药，因此临床必须重视合理使用抗菌药物，以减少或延缓多重耐药菌株的产生。
【关键词】肺炎克雷伯菌；医院感染；耐药性；超广谱β-内酰胺酶
【中图分类号】R378【文献标识码】A【文章编号】1008-6455(2011)04-0521-02
Distribution and Antibiotic Resistance of Klebsiella pneumoniae in Hospital of 2010
Feng Tao* He Shiyan An Cuiping et al.
【Abstract】Objective:To investigate the distribution and situation of antibiotic resistance of klebsiella pneumoniae isolated from our hospital in 2010, so as to provide reference for antimicrobial treatment. Methods:A total of 448 strains of klebsiella pneumoniae were retrospectively analyzed according to the source of specimens, infections in different departments and drug-resistance. Results:More than 96.0% klebsiella pneumoniae were found to be sensitive to the carbopenems (ie. imipenem and meropenem) as well as those compound preparations (ie. cefoperazone/sulbactam and piperacillin/tazobactam). However, to other kinds of antibiotic drugs, the drug resistance of klebsiella pneumoniae was serious. In the investigation, the highest resistance rate of klebsiella pneumoniae was present in the penicillins as ampicillin and the cephalosporins as cefazolin, cefuroxime, ceftriaxone and cefotaxime, all of them showed a critical drug resistance (more than 50.0%). Simultaneously, to amikacin, isepamicin and levofloxacin, ciprofloxacin, which respectively belonging to aminoglycosides and quinolones, a lower resistance rate of klebsiella pneumoniae varied from 20.0% to 30.0% was confirmed. Conclusion:Klebsiella pneumoniae, isolated from the patients, has shown a high rate of resistance to routine antimicrobial agents, and even has presented multiple antibacterial resistance. So we must keep an eye on the nosocomial infection and rationally use the antimicrobial agents in order to decrease or delay the production of multi-drug resistant strains ......
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