我院临床标本中肺炎克雷伯菌分布及耐药性剖析.docVIP

我院临床标本中肺炎克雷伯菌分布及耐药性剖析 　　【摘要】 目的 了解近2年来肺炎克雷伯菌标本的来源构成及耐药情况,以指导临床合理用药。方法 对2008年1月至2009年12月间的各类临床标本进行分离培养,用天地人微生物分析系统生化试验卡鉴定,并用天地人微生物分析系统相配套的药敏试验卡进行药敏试验。结果 共分离肺炎克雷伯菌213株;主要来源于痰标本(54.46%);连续2年对美洛培南无耐药株,耐药率低的其次是阿米卡星(8.45%)、哌拉西林/他唑巴坦(12.21%);对氨苄西林耐药率为100%。肺炎克雷伯菌ESBLs阳性率为22.54%,产ESBLs肺炎克雷伯菌的耐药率远远高于非产ESBLs的菌株。结论 美洛培南是治疗产ESBLs肺炎克雷伯菌的首选药物。应采取相应的措施控制肺炎克雷伯菌导致的医院感染流行及产ESBLs菌株的产生。 　　【关键词】 　　肺炎克雷伯菌;超广谱β-内酰胺酶;抗菌药物 　　 　　Analysis of distribution and resistantce of the K.pneumoniae in our hospitalQUAN Zhuang-zhi,ZENG Jian-gao.Department of Clinical Laboratory,Central Hospital of Yiyang city,Hunan Province 413000,China 　　【Abstract】 Objective To investigate the composing of origin and resistantce circs of the K.pneumoniae in our hospital during the recent 2 years,so as to direct rationally clinic use of drugs.Methods The different kinds of bacteria specimens were gathered from our hospital between Jan.2008 and Dec.2009,which were cultured,isolated and identified with “TIANDIREN”microbial identification system,and the resistance sensitivity test was detected with test card corresponding to“TIANDIREN”microbial identification system.Results A total of 213 strains of K.pneumoniae were isolated,mostly from the sputum(54.46%);there were not sensitive to Meropenem in lastest 2 years,secondly low drug-resistance were Amikacin(8.45%)and Piperacillin/Tazobactam(12.21%).The K.pneumoniae strains were sensitive to carbapenems such as Ampicillin(100%).The ESBLs electropositive rate was 22.54%in K.pneumoniae,and resistant rates of ESBLs producing strains were much higher than ESBLs nonproducing strains.Conclusion Meropenem is the best drugs to cure the K.pneumoniae,which can produce the ESBLs.We should take corresponding measures to control the occurrence of the nosocomial infections caused by K.pneumoniae and the produce of ESBLs strains. 　　【Key words】 　　K.pneumoniae;ESBLs;Antibacterial 　　 　　肺炎克雷伯菌是导致肺炎的主要病原菌,还可引起肺外其他部位感染,是产超广谱β-内酰胺酶(ESBLs)的主要肠道菌株,对多种抗菌药物耐药,给治疗带来困难[1],因此加强对肺炎克雷伯菌的耐药性分析,对有效治