肺炎克雷伯菌医院感染的临床特点与耐药性分析

目的了解肺炎克雷伯菌医院感染的临床特点与耐药特征。方法分析2008年1月～2010年12月195例肺炎克雷伯菌医院感染患者的临床资料,采用K-B纸片扩散法进行药敏试验及ESBLs的表型筛选和确证试验。结果医院感染肺炎克雷伯菌标本主要来源依次为痰液、血液、胆汁和尿液;检出科室以重症监护室、肝胆外科、神经外科和血液内科为主;大部分患者存在严重基础疾病和导致感染的危险因素;肺炎克雷伯菌对亚胺培南最敏感;产ESBLs菌株检出率为50.3%;产ESBLs菌株耐药率明显高于非产ESBLs株。结论 ESBLs在肺炎克雷伯菌医院感染中十分流行,多重耐药明显,做好细菌耐药性监测,合理使用抗生素十分重要。

Analysis of Clinical Characteristics and Antimicrobial Resistance of Nosocomial Klebsiella Pneumoniae

Objective To investigate the clinical characteristics and antimicrobial resistance of nosocomial Klebsiella pneumoniae（Kpn）.Methods Clinical data of 195 cases of nosocomial infections with Kpn were analyzed,antimicrobial susceptibility tests and confirmatory tests for extended spectrum β-lactamases（ESBLs） were done by Kirby-Bauer diffusions methods.Results Kpn was isolated mostly from sputum,blood,bile and urine.Infections caused by Kpn frequently occurred in intensive care units,department of hepatobiliary surgery,department of neurosurgery and hematology.Most patients had severe underlying diseases and risk factors of infections.Kpn was the most sensitive to imipenem.The isolated rate of Kpn producing ESBLs was 50.3%.The resistant rate of ESBLs strains was significantly higher than the non-ESBLs strains.Conclusion ESBLs are popular in nosocomial Kpn.Multiple drug-resistant is obvious in ESBLs strains.Monitoring bacterial resistance and reasonable use of antibiotics are very important.