我院肺炎克雷伯杆菌耐药性调查及分析.docVIP

我院肺炎克雷伯杆菌耐药性调查及分析[摘要] 目的:了解和掌握2007年1月～2009年9月我院肺炎克雷伯杆菌的耐药性变化的趋势,加以分析,为临床治疗提供可靠依据。方法:采用美国德灵公司的Walk Away 40系统及VITEK 2系统进行细菌鉴定,用K-B法及VITEK 2进行药物敏感性试验,用WHONET 5.3软件分析细菌的耐药性。结果:近3年的时间里肺炎克雷伯杆菌对9种常用抗菌药物的耐药率存在普遍的增高趋势,对其中喹诺酮类抗菌药物的耐药率变化显著。结论:及时有效的细菌鉴定及药物敏感性实验,尽早发现肺炎克雷伯杆菌的院内感染情况,能够为临床提供重要的实验依据。 [关键词] 肺炎克雷伯杆菌;耐药性;调查分析 [中图分类号] R181.34[文献标识码] A [文章编号] 1673-7210(2010)04(a)-228-02 Investigation and analysis of the antimicrobial resistance in Klebsiella pneumoniae ZHANG Liyan, ZHANG Xiulin, CHEN Lin (The Third Peoples’ Hospital of Dalian, Dalian 116037, China) [Abstract] Objective: To investigate the change of antimicrobial in klebsiella pneumoniae in the three the peoples’ hospital of Dalian from January 2007 to September 2009. Methods: Klebsiella pneumoniae was identified by Walk Away 40 and VITEK 2 system (Virtue clever corporate), and its antimicrobial resistance was determined by Kirby-Bauer method and VITEK 2 system. The antimicrobial resistance rates were analyzed by WHONET 5.3 software (World Health Organization). Results: The antimicrobial resistance rates of klebsiella pneumoniae to 9 common antimicrobial drugs increased in the past contiguity 3 years, and the resistance rates to quinolones antimicrobial drugs increased significantly. Conclusion: Timely identifying bacteria and performing drug sensitivity tests may help find out nosocomial infection of klebsiella pneumoniae and thus provide important laboratory evidence for clinical treatment. [Key words] Klebsiella pneumoniae; Antimicrobial resistance; Investigation and analysis 肺炎克雷伯杆菌为条件致病菌,是目前医院感染主要的病原菌之一,且往往对多种抗菌药物耐药。近年来随着抗菌药物特别是第三代头孢菌素的广泛应用,出现了产超广谱β-内酰胺酶(ESBLs)的革兰阴性杆菌,肺炎克雷伯杆菌感染有明显增加趋势,已成为医院内感染的重要致病菌之一。因此,肺炎克雷伯杆菌的耐药性调查对于正确选用抗菌药物和控制院内感染都有重要价值。肺炎克雷伯菌是最常见的产超广谱β-内酰胺酶(ESBLs)菌株,常引起医院感染暴发流行。尤其肺炎克雷伯菌导致细菌产生耐药性给临床治疗带来了一定的困难。 1 资料与方法 1.1 一般资料 所有标本均来源于2007年1月～2009年9月在我院就诊患者的血液、痰、尿、分泌物、脓汁等标本。 1.2 仪器与试剂 药敏纸片(头孢曲松、哌拉西林/他唑巴坦)等均为英国OXOD公司产品;鉴定采用美国德灵公司的Walk Away 40系统及VITEK 2系统;MH琼脂为OXOD公司产品。 1.3