2010～2012年院内产超广谱β―内酰胺酶肺炎克雷伯菌的感染状况及耐药分析.docVIP

2010～2012年院内产超广谱β―内酰胺酶肺炎克雷伯菌的感染状况及耐药分析 　　[摘要] 目的 了解平湖市第二人民医院（以下简称“我院”）内产超广谱β-内酰胺酶（ESBLs）的肺炎克雷伯菌临床感染及耐药情况，为临床用药物提供参考。 方法 对2010年1月～2012年12月我院临床送检标本中分离出的肺炎克雷伯菌产ESBLs率及其耐药性进行分析。 结果 产ESBLs的肺炎克雷伯菌总检出率为35.6%，并且每年有递增的态势。产ESBLs的肺炎克雷伯菌对青霉素类和头孢菌素类的耐药率极高；对庆大霉素、环丙沙星、左氧氟沙星有较高的耐药性；对哌拉西林/他唑巴坦、阿米卡星和呋喃妥因较敏感；对亚胺培南不耐药。 结论 肺炎克雷伯菌存在比较严重的耐药性，临床应重视细菌培养，并合理使用抗菌药物。 　　[关键词] 超广谱β-内酰胺酶；耐药性；肺炎克雷伯菌 　　[中图分类号] R446.5 [文献标识码] A [文章编号] 1673-7210（2014）02（b）-0028-03 　　Analysis of infection status and drug resistance of ESBLs-product Klebsiella pneumoniae in our hospital from 2010 to 2012 　　DING Lin1 LING Liyan1 DUAN Darong2 　　1.Department of Laboratory， the Second Peoples Hospital of Pinghu City， Zhejiang Province， Pinghu 314201， China； 2.Department of Bacteriology， the First Peoples Hospital of Taizhou City， Zhejiang Province， Taizhou 318000， China 　　[Abstract] Objective To investigate the clinical infection and drug resistance of producing extended spectrum beta-lactamases （ESBLs） of Klebsiella pneumoniae in the Second Peoples Hospital of Pinghu City （“our hospital” for short）， and to provide guidance for clinical application of antibiotics. Methods The percent of Klebsiella pneumonia which produce ESBLs and its drug resistance and in our hospital from January 2010 to December 2012 was collected and analyzed. Results ESBLs-producing Klebsiella pneumoniae accounted for 35.6% and there was an increasing trend year by year. The producing ESBLs Klebsiella pneumoniae exhibited extremely high resistance to penicillin and cephalosporin， higher resistance to Penicillin， Ciprofloxacin， Levofloxacin， sensitive to Piperacillin/Tazobactam， Amikacin and Nitrofurantoin. There was no resistance observed to Imipenem. Conclusion There is serious drug resistance for Klebsiella pneumoniae clinical use. It is necessary to pay more attention to the clinical bacterial culture and clinical used drugs. 　　[Key words] Extended-spectrum β-lactamases； Drug resistance； Klebsiella pneumonia 　　肺炎克雷伯菌可引起肺炎、尿路感染、败血症、伤口感