医院产超广谱β-内酰胺酶肺炎克雷伯菌的耐药性分析

目的 研究医院产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌(KPN)的耐药现状,为临床用药提供依据.方法 将医院分离KPN的药敏试验结果应用WHONET 5.5软件进行统计学分析.产ESBLs菌株采用双纸片协同实验测定并经CLSI确证试验确认.结果 13年中KPN和产ESBLs KPN的分离率为18.7%和75.3%,产ESBLs菌株的耐药率远高于非产ESBLs菌株.除亚胺培南、阿米卡星和左氧氟沙星对产ESBLs KPN敏感率高外,其他抗菌药物耐药严重.结论医院应加强对产ESBLs菌株的监控,防止多药耐药菌的传播.碳青霉烯类是治疗产ESBLs KPN最有效的药物.

Drug resistance of extended spectrum beta-lactamases producing klebsiella pneumoniae in hospital

Objective To provide basis for clinical medication by investigating the drug resistance status of extended spectrum beta-lactamases(ESBLs) producing klebsiella pneumoniae(KPN).To provide reference for clinical treatment and infection control in our hospital.Methods The drug susceptibility was tested by Kirby-Bauer method.The data of drug susceptibility tested were analyzed by WHONET 5.5 software.ESBLs producing strain was tested by double disk test and confirmed by CLSI confirmatory test.Results The isolated ratio of KPN and ESBLs producing KPN were 18.7% and 75.3% during 1999-2011.The resistance rates of ESBLs producing strains to most antibiotics were much higher than those of non-ESBLs producing strains.The highest susceptibility to ESBLs producing strains were imipenem,amikacin and levofloxacin.The drug resistance of the other antibiotics were serious.Conclusion Hospital should strengthen the monitoring and controlling of drug resistance to prevent the occurrence and prevalence of multidrug-resistant strains causing nosocomial infection.Carbopenem could be the most effective antibiotics to treat the infection caused by ESBLs producing KPN in clinic.