下呼吸道肺炎克雷伯菌ESBLs检测及耐药性分析.docVIP

下呼吸道肺炎克雷伯菌ESBLs检测及耐药性分析 　　[摘要] 目的 探讨下呼吸道感染肺炎克雷伯菌的超广谱β-内酰胺酶（ESBLs）的检测及耐药性分析。方法 对下呼吸道感染患者中分离的135株肺炎克雷伯菌的耐药性及产ESBLs菌进行分析。结果 从135株肺炎克雷伯菌中检出产ESBLs菌株58株，检出率高达43.0%。除亚胺培南外，产ESBLs菌株对15种抗生素的耐药性均高于非产ESBLs菌株（P＜0.01）。结论 ESBLs是下呼吸道感染肺炎克雷伯菌产生耐药性的主要原因，临床上经验用药可选择头霉素类、β-内酰胺类/β-内酰胺酶抑制剂和碳青霉烯类抗生素。 　　[关键词] 下呼吸道感染；肺炎克雷伯菌；超广谱β-内酰胺酶；耐药性 　　[中图分类号] R725.6 [文献标识码] B [文章编号] 1673-9701（2011）34-77-02 　　 　　Lower Respiratory Tract Klebsiella Pneumoniae Infection：Detection and Susceptibility of Tts Extended Spectrum β-lactamase 　　YE Junpan1 LUO Lifei2 　　1.Department of Respiratory，Tiantai Traditional Chinese Medical Hospital，Tiantai 317200，China；2.Department of Clinical Laboratory，Taizhou Hospital of Luqiao Branch，Taizhou 318050，China 　　 　　[Abstract] Objective To detect and analyze the susceptility of the extend spectrum β-lactamase which was produced by klebsiella pneumoniae in lower respiratory tract infection. Methods All of 135 strains of Klebsiella Pneumoniae separated from patients of lower respiratory infection were choosed，and its susceptibility and ability of ESBLs-producing were analyzed. Results All 58 ESBLs-producing strains were determinded from 135 strains of Klebsiella Pneumoniae（43.0%）.Except Imipinem，the resistant rates of ESBLs producing strains to 15 antibiotics were much higher than that of non ESBLs producing strains（P＜0.01）. Conclusion ESBLs-producing maybe the main reason of the drug resistance of klebsiella pneumoniae，so we can clinicly choose antibiotics as kind of cephamycins，β-lactams/β-lactamase inhibitors and carbopenems as empirical treatment. 　　[Key words] Lower respiratory infection；Klebsiella pneumoniae；Extended spectrum β-lactamase；Drug resistance 　　 　　肺炎克雷伯菌是目前引起下呼吸道感染和肺部感染最常见的病原菌之一，近年来其耐药性逐年上升，主要原因是由于产生了产超广谱β-内酰胺酶（ESBLs）[1]。本文现对我院从2008年1月～2011年7月收???的下呼吸道感染患者中分离出的135株肺炎克雷伯菌的耐药性及产ESBLs进行分析，现报道如下。 　　 　　1 资料与方法 　　1.1 临床资料 　　选择2008年1月～2011年7月从我院呼吸科门诊或住院治疗的下呼吸道感染患者分离的肺炎克雷伯菌135株。取晨起合格的痰标本按照《全国临床检验操作规程》进行肺炎克雷伯菌的分离与培养，并采用法国Vitek-32型微生物分析仪与GNI+鉴定卡进行菌株鉴定，加吲