1996-2005年上海地区临床分离肺炎克雷伯菌耐药性变迁

目的了解临床分离肺炎克雷伯菌对抗菌药物耐药性变迁情况。方法对1996-2005年上海地区11所医院细菌耐药监测资料中肺炎克雷伯菌临床分离株的耐药性进行分析,细菌药敏采用K-B法。结果临床分离肺炎克雷伯菌对抗菌药物药敏试验结果显示,该菌对哌拉西林和第一、二代头孢菌素耐药率一直很高;对头孢噻肟(29.3%~45.2%)和哌拉西林/他唑巴坦(5.1%~20.6%)的耐药率明显上升;对氟喹诺酮类耐药性亦有增长,且各品种间呈交叉耐药;对碳青酶烯类仍呈高度敏感;2000-2005年该菌产ESBLs者增多(30.1%~42.0%)。结论临床分离肺炎克雷伯菌对常用抗菌药物的耐药性10年间呈普遍增长趋势。

Changes in Antimicrobial Resistance among Clinical Isolates of Klebsiella pneumoniae in Shanghai 1996-2005

OBJECTIVE To investigate the trend of resistance of antimicrobial agents among clinical isolates of Klebsiella pneumoniae 1996-2005.METHODS Agar diffusion test was used to analyze the changes in drug susceptibility of K.pneumoniae isolated from 11 hospitals in Shanghai to antimicrobial agents.RESULTS The resistance rates of K.pneumoniae to antimicrobial agents mostly increased 1996-2005.The resistance rates to piperacillin,cefazolin and cefuroxime remained at high levels(more than 50%),while which to cefotaxime(29.3-45.2%) and piperacillin/tazobactam(5.1-20.6%) were increased obviously.Carbapenems were the most active agents against the K.pneumoniae isolates.The resistance rates to ciprofloxacin increased from 14.4% to 35.8%.The detectable rate of extended-spectrum beta-lactamases-producing strains in K.pneumoniae increased from 30.1% to 42.0%.CONCLUSIONS The trend of resistance of K.pneumoniae to commonly used antimicrobials was upward 1996-2005.