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洪亚明.348株肺炎克雷伯菌感染的临床分布与耐药性的分析[J].浙江中西医结合杂志,2014,24(9):
348株肺炎克雷伯菌感染的临床分布与耐药性的分析
Distribution and antibiotic resistance of 348 isolates of Klebsiella pneumoniae
投稿时间:2014-01-20  修订日期:2014-01-20
DOI:
中文关键词:  肺炎克雷伯菌  超广谱β内酰胺酶  耐药性
英文关键词:Klebsiella pneumoniae  Extended-spectrum beta-lactamases  drug resistance
基金项目:
作者单位E-mail
洪亚明 富阳市人民医院检验科 45807782@qq.com 
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中文摘要:
      目的 了解肺炎克雷伯菌感染的临床分布及其对常用抗菌药物的耐药性,为临床预防和控制感染提供依据。方法 收集2012年1月-2013年12月从临床标本中分离的肺炎克雷伯菌,采用VITEK2进行鉴定和药敏。结果 从各类标本中共分离出肺炎克雷伯菌348株,标本来源以痰为主,占82.2%;尿占8.1%。感染分布以呼吸内科为主。肺炎克雷伯菌产ESBLs率为20.11%,产ESBLs菌株耐药率显著高于非产ESBLs菌株,非产ESBLs肺炎克雷伯菌对氨苄西林、、呋喃妥因耐药率较高,分别为100%, 35.2%,对其他常见药物耐药率均<11.5%;而产ESBL的肺炎克雷伯菌对碳青霉烯类(亚胺培南)、含酶抑制剂 (头孢哌酮/舒巴坦)、氨基糖苷类(丁胺卡那)及第四代头孢菌素(头孢吡肟)抗生菌药物敏感,对其他抗菌药物耐药率均较高。结论 肺炎克雷伯菌是医院感染的重要致病菌,及时监测产ESBLs菌的发生率与耐药趋势对指导临床用药有重要意义
英文摘要:
      OBJECTIVE To investigate the distribution and antibiotic resistance of Klebsiella pneumoniae isolated so as to provide basis for clinical prevention and infection control. METHODS Collect Klebsiella pneumoniae isolated from clinical samples during the period of Jan 2012 –Dec 2013. VITEK-32 auto-microbial-evaluation instrument was utilized in identification and drug sensitivity test. RESULTS Totally 348 strains of Klebsiella pneumoniae were isolated from various specimens. The K. pneumonia-positive specimens were mostly derived from sputum (82.2%) and urine (8.1%). Infection mainly distributed in respiratory department. ESBLs-producing K. pneumoniae was detected in 20.11% of the isolates. The rates of resistance to most antibiotics in ESBL-positive K. pneumoniae were higher than ESBL-negative counterparts. The ESBL-negative pneumoniae has rather higher drug resistance rate to ampicillin and nitrofurantoin—at 100% and 35.2% respectively. Its drug resistance rate to other common drugs was less than 11.5%. The ESBLs-producing K. pneumoniae was susceptible to carbapenem antibiotic (imipenem), drugs containing enzyme inhibitor (cefoperazone/ sulbactam), aminoglycosides antibiotics (amikacin) and the fourth-generation cephalosporins (cefepime). Besides, it has a higher antimicrobial resistance rate to other antibiotic agents. CONCLUSION Klebsiella pneumoniae is an important pathogen of nosocomial infection and timely monitoring the incidence of ESBLs-producing K. pneumoniae and its drug resistance tendency have important implications to guide the clinical medication.
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