大肠埃希菌和肺炎克雷伯菌药敏分析

目的：研究大肠埃希菌和肺炎克雷伯菌的耐药性及不同标本来源和不同病区的大肠埃希菌和肺炎克雷伯菌耐药性的差异。方法：应用WHONET5．5对四川省人民医院2011年802株大肠埃希菌和580株肺炎克雷伯菌的药敏结果进行分析。结果：大肠埃希菌耐药率最低的为亚胺培南（0．2％）、厄他培南（1．4％）、头孢替坦（1．8％），其次为哌拉西林／他唑巴坦（3．0％）、阿米卡星（4．0％）、呋喃妥因（4．5％）。肺炎克雷伯菌耐药率低的抗生素依次为亚胺培南（3．2％）、阿米卡星（3．3％）、头孢替坦（4．9％）、厄他培南（6．8％）、哌拉西林／他唑巴坦（8．0％）。ESBLs检出率大肠埃希菌为61．8％，肺炎克雷伯菌为35．5％。肺炎克雷伯菌在尿液标本中的敏感率较痰液、血液、其他无菌体液低。大肠埃希菌和肺炎克雷伯菌在儿科的敏感率高于内外科及ICU病房。结论：大肠埃希菌和肺炎克雷伯菌属对碳青霉烯类抗生素、头霉素类和哌拉西林-他唑巴坦仍保持高度敏感性。不同标本来源和不同病区的大肠埃希菌和肺炎克雷伯菌药敏存在差异。临床治疗应根据药敏结果合理选用抗生素。

Analysis of Escherichia Coli and Klebsiella Pneumoniae Drug Sensitivity

Objective： To research the antibiotic resistance difference between Escherichia coli and Klebsiella pneumoniae strains from different specimens sources and different wards.Method ： The drug susceptibility results from 802 strains of Escherichia coli and 802 strains Klebsiella pneumoniae of the Sichuan Provincial People＇s Hospital in 2011 were analysed by WHONET 5.5.Result： Escherichia coli experienced low antibiotic resistance rates to imipenem （ 0.2% ）, ertapenem （ 1.4% ）, cefotetan （ 1.8% ）, followed by piperacillin/tazobactam （ 3.0% ）, amikacin （ 4.0% ）, nitrofurantoin （ 4.5% ）. Low-level antibiotic resistance in Klebsiella pneumoniae were followed by imipenem （ 3.2% ）, amikacin （ 3.3% ）, cefotetan （ 4.9% ）, ertapenem （ 6.8% ）, piperacillin/hetazobactam （ 8.0% ） .ESBL-producing strains accounted for 61.8% in Escherichia coli and 35.5% in Klebsiella pneumoniae.Klebsielia pneumoniae showed low antibiotic sensitivity in urine specimens than sputum, blood and other sterile body fluids.Sensitivity of Escherichia coli and Klebsiella pneumoniae in pediatric ward was higher than medical, surgical and ICU ward.Conclusion： Escherichia coli and Klebsiella pneumoniae still maintain a high degree of sensitivity to carbapenem antibiotic, cephamycins and piperacillin-tazobactam.Escherichia coli and Klebsiella pneumoniae from different specimens sources and different ward exist different antibiotic susceptibility.The use of antibiotics in clinical treatment should be based on susceptibility results.