肺炎克雷伯菌的分布特征及耐药性分析

目的分析该院2014年肺炎克雷伯菌(KPN)分离株的分布情况及其耐药性。方法使用西门子医学诊断公司的M/W-96全自动细菌鉴定/药敏鉴定仪对临床KPN分离株进行药敏试验,细菌药敏结果根据2012版临床和实验室标准协会(CLSI)M100-S22文件判读。结果 8 486例送检标本共检出KPN 291株,其中KPN药敏株(DS-KPN)213株,肺炎克雷伯菌多重耐药株(MDR-KPN)20株,产超广谱β-内酰胺酶肺炎克雷伯菌(ESBLs-KPN)48株,碳青霉烯类耐药肺炎克雷伯菌(CR-KPN)10株。不同标本KPN检出率差异有统计学意义(P=0.000),痰标本构成比最高(P=0.000);不同病房KPN检出率差异有统计学意义(P=0.000),呼吸病房构成比最高(P=0.000);KPN对不同抗菌药物耐药率、敏感率差异有统计学意义(P=0.000),碳青霉烯类抗菌药物耐药率最低。结论 KPN对常用抗菌药物耐药率相对较低,其多重耐药株耐药率处于较高水平,必须引起临床和院感部门的重视,并采取一定的监管措施。

Analysis on distribution characteristics and drug resistance of Klebsiella pneumoniae

Objective ToanalyzethedistributionanddrugresistancesituationofKlebsiellapneumoniae(KPN)isolatedfromour hospital during 2014 .Methods The drug susceptibility test was carried out by the Siemens fully automatic bacterial identification /drug susceptibility test analyzer .The drug susceptibility test results were judged according to the (CLSI) M100‐S22 document (2012) .Results A total of 291 strains of KPN were detected from 8 486 submitted specimens ,in which 20 strains were multi‐drug resistant Klebsiella pneumoniae(MDR‐KPN)isolates were 213 strains ,48 strains were extended‐spectrum beta‐lactamases producing Klebsiella pneumoniae (ESBLs‐KPN) and 10 strains were carbapenem‐resistant Klebsiella pneumoniae(CR‐KPN) .The KPN detec‐tion rate had statistical difference among different specimens (P= 0 .000) .The constituent ratio of KPN isolation in the sputum specimen was highest(P=0 .000) .The KPN detection rate had statistical difference among different departments (P=0 .000) ,the constituent ratio of KPN isolation in the respiration department was highest (P=0 .000) .The resistance and sensitivity of KPN to different antibacterial drugs had statistical difference(P=0 .000) ,carbapenems had the lowest resistance rate .Conclusion KPN has relatively low resistance rate to commonly used antibacterial drugs ,its multi‐drug resistant strains are in the higher level ,which should arouse clinic and hospital infection management department must to pay attention to and adopt corresponding supervision measures .