患儿肺炎克雷伯菌感染及耐药性动态观察

目的分析吉林市三级甲等医院2004年1月～2006年12月呼吸系统感染患儿肺炎克雷伯菌感染现状及耐药性的变化,为临床合理选用抗菌药物提供依据。方法对呼吸道感染标本进行常规微生物培养,分离株鉴定肺炎克雷伯菌并用15种抗生素对其进行药敏试验。结果2004～2006年患儿呼吸道感染标本共分离出135株肺炎克雷伯菌,检出率分布为：2004年30.0%,2005年34.2%,2006年48.3%。肺炎克雷伯菌临床分离株对氨苄西林、哌拉西林、头孢唑啉、头孢呋辛耐药率为58.3%～100%,对其余11种抗生素耐药率逐年上升。结论呼吸系统感染患儿中肺炎克雷伯菌检出率高,治疗中应严格掌握抗菌药物应用指征,并动态监测其耐药性,防止肺炎克雷伯菌的暴发感染。

Dynamic observation of pediatric patients infected with Klebsiella pneumoniae and its drug resistance

Objective To analyze the state of infection and changes in drug resistance for Klebsiella pneumoniae from January 2004 to December 2006 in a tertiary care hospital in the City of Jilin and to provide a basis for the rational clinical use of antibiotics.Methods Pediatric respiratory tract specimens were subjected to routine microbiological culture,K.pneumoniae was isolated and identified,and 15 kinds of antibiotic sensitivity tests were performed.Results From 2004-2006,135 strains of K.pneumoniae were isolated from pediatric respiratory tract specimens with a detection rate of 30.0% in 2004, 34.2% in 2005, and 48.3% in 2006. The antibiotic resistance rate of K. pneumoniae clinical isolates to ampicillin, piperacillin, cefazolin and cefuroxime was 58.3 %- 100%, and rates of resistance to the remaining 11 types of antibiotics have risen each year. Conclusion K. pneumoniae was detected from pediatric respiratory tract specimens at a high rate. Indications for the use of antimicrobials in clinical treatment should be strictly controlled, and dynamic monitoring of K. pneumoniae＇s resistance should be performed to prevent an outbreak of infection.