238株肺炎克雷伯菌的临床分布和耐药分析.pdfVIP

安 徽 医 学 第 33 卷第 6 期 652 Anhui1 Medical1 Journal 2012 年 6 月 238 株肺炎克雷伯菌的临床分布和耐药分析 汪 滢 李家斌 ［摘 要］ 目的 了解各种临床标本中肺炎克雷伯菌的临床分布特点和一般性耐药情况。 方法 收集 2011 年 9 月安徽省 32 家医 院报送的肺炎克雷伯杆菌，药敏试验采用琼脂稀释法，结果依据 CLSI 2010 年推荐的标准进行判读。 结果 肺炎克雷伯菌主要来自痰标 本，占 76.05% ；主要分布于 ICU 和呼吸内科，明显多于其他病房。药敏结果显示，肺炎克雷伯菌对 2、3 代头孢菌素表现出较高的耐药性，耐 药率在 28.2%~68.5% ；对 4 代头孢菌素头孢吡肟比较敏感，耐药率为 28.2% ；对喹诺酮类的敏感率在 70%左右；氨基糖苷类中的阿米卡星 耐药率较低，为 19.7%，而庆大霉素为 70.6% ；加酶抑制剂的抗菌药物比不加酶抑制剂的耐药率低很多；拉氧头孢、美罗培南和亚胺培南对 该菌的敏感性最高。 结论 肺炎克雷伯菌临床分离株数多，耐药率较高，应加强临床使用抗菌药物的管理，预防和减少多重耐药菌株的 产生。 ［关键词］ 肺炎克雷伯杆菌；细菌耐药监测；耐药性 doi ：10.3969/j.issn.1000-0399.2012.06.002 Clinical distribution and analysis of drug susceptibility of 238 clinical isolates of Klebsiella pneumonia Wang Ying ， Li Jiabin Department of Nutrition ， the No. 306 Hospital of the People s Liberation Army ， Beij ing 100 10 1， China [Abstract] Objective To analyze the clinical distribution and antimicrobial resistance of Klebsiella pneumonia in order to provide the scientific evidence for clinical diagnosis and treatment. Methods The antimicrobial susceptibility test to 238 strains of Klebsiella pneumonia was performed by agar dilution method. The results were judged according to the criteria recommended by Clinical and Laboratory Standards Institute （CLSI ）2010. Results Most Klebsiella pneumonia came from sputum sample, which accounted for 76.05%. The bacteria was fre－ quently distributed in ICU and Department of Respriratory. The results of antimicrobial susceptibility test showed that Klebsiella pneumonia was highly resistant to the 2nd and 3rd generation cephalosporins (28.2%~68.5%), but sensitive to levofloxacin, gatifloxacin, and the 4th generati