肺炎克雷伯菌的耐药性分析

目的了解肺炎克雷伯菌体外对抗生素的耐药情况，为临床诊治提供参考。方法采用纸片扩散法（K—B）法对临床分离的肺炎克雷伯菌进行药敏检测，并用双纸片法初筛、确证法检测产超广谱β-内酰胺酶（Extended spectrum beta-lactamases，ESBLs）菌。结果140株肺炎克雷伯菌的ESBLs阳性率为40．6％，对替卡西林＋棒酸（TCC）总的耐药率最高为97．9％，除阿米卡星（AMK）和亚胺培南（IMI）以外对其余10种药物的总耐药率均超过50％，对亚胺培南的总耐药率仅为3．6％。产ESBLs与非产ESBLs菌对TCC和亚胺培南的耐药率比较无显著性差异（P〉0．05），对其余10种药物的耐药率比较均有显著性差异（P〈0．01）。结论肺炎克雷伯菌是主要的产ESBLs条件致病菌之一，临床应加强对肺炎克雷伯菌耐药性的监测并预防耐药菌株的传播流行。

Analysis of drug resistance of Klebsiella pneumoniae

Objective To investigate the drug resistance of clinical isolates of Klebsiella pneumoniae in our hospital for providing clinical reference. Methods Antimicrobial susceptibility test is analyzed by K - B paper scraps spread method. The extended spectrum beta - lactamases （ESBLs） producing strains were detected by double disc test and confirmed test. Results The ESBLs positive rate of Klebsiella pneumoniae was 40.6%. The highest resistance of Klebsiella pneumoniae to TCC was 97.9% and the resistance to other 10 antibiotics was over 50% except amikacin and imipenem. The resistance to imipenem was 3.6%. There no significant statistical differences were observed in resistance of ESBLs producing strains and non - ESBLs producing strains to TCC and imipenem （ P 〉 0.05 ）. There were significant statistical differences were observed in resistance of ESBLs -producing strains and non -ESBLs producing strains to other 10 antibiotics （P 〈 0.01 ）. Conclusion The Klebsiella pneumoniae which produced ESBLs strains is one of the main of opportunistic infection strains. Thus monitoring activities be carried out for preventing the prevalence of resistant Klebsiella pneumoniae strains.