肺炎克雷伯菌临床分离株的流行病学及耐药特性

目的 探讨医院肺炎克雷伯菌(KPN)临床分离株的流行病学及耐药性,为临床医师合理选用抗菌药物提供参考依据.方法 对266株肺炎克雷伯菌的标本来源和临床科室分布进行调查；细菌鉴定按照《全国临床检验操作规程》,采用常规方法鉴定；药敏试验采用K-B法进行,依据CLSI最新折点判读结果；数据处理应用WHO-NET软件分析.结果 医院肺炎克雷伯菌主要分离自呼吸道标本,占60.5％；以呼吸内科、ICU、脑外科、神经内科分离率较高,分别占20.7％、19.2％、15.8％、14.3％；肺炎克雷伯菌临床株对碳青霉烯类抗菌药物亚胺培南、美罗培南敏感率为100.0％,但对其他常用抗菌药物均产生了不同程度的耐药性.结论 医院应继续坚持细菌耐药性的监测工作,预防与控制多药耐药细菌医院感染的暴发流行.

Epidemiology and drug resistance of clinical isolates of Klebsiella pneumoniae

OBJECTIVE To investigate the epidemiology and antibiotic resistance of clinical isolates of Klebsiella pneumoniae so as to provide reference for clinically reasonable use of antibiotics.METHODS The specimen sources and the clinical distribution of 266 isolates of K.pneumoniae were investigated.Referring to National Guide to Clinical Laboratory Procedures,the identification of the bacteria was carried out by the routine methods.Antibiotic susceptibility testing was performed by K-B methods and the result was read according to the latest version of CLSI.The WHONET software was used to analyze the data.RESULTS K.pneumoniae isolates were mainly isolated from the respiratory tract,accounting for 60.5%;the isolation rates of K.pneumoniae were relatively high in department of respiratory medicine(20.7%),ICU(19.2%),department of cerebral surgery(15.8%),and department of neurology(14.3%).The result of the drug susceptibility testing showed that K.pneumoniae was 100.0% suscertble to carbapenems such as imipenem and meropenem and varied in the drug resistance to other commonly used antibiotics.CONCLUSION The hospital should continue to adhere to the monitoring of bacterial resistance so as to prevent and control the outbreak and prevalence of nosocomial infections caused by multidrug-resistant strains.