207株小儿肺炎克雷伯菌分布特征及耐药性分析

目的 分析肺炎克雷伯菌在儿科及新生儿科f临床感染中的耐药特征，指导临床合理用药。方法 采用ATB Expression全自动细菌鉴定和药敏测试仪对20种抗菌药物进行敏感性试验及ESBL检测，ESBL阳性菌株以标准纸片扩散法进行表型确证。结果 207株肺炎克雷伯菌有77．3％来源于粪便标本，18．8％来源于痰液标本，对亚胺培南和美洛匹宁的敏感率高达100％，其次是复方哌拉西林、复方阿莫西林和头孢西丁，敏感率分别为98％、96％和96％，头孢菌素类敏感性较差。其中有50株产ESBL，占24．2％。结论　肺炎克雷伯菌ESBL阳性率及多重耐药率高，对除亚胺培南和美洛匹宁外的抗菌药物均有不同程度的耐药，含酶抑制剂的青霉素类复合剂敏感性仅次于上述两者，且经济、有效，故从药物经济学评价考虑，小儿感染临床可根据药敏提示首选该类药物。

Distribution Characteristic and Drug Reisitance Analysis of 207 Children Infected Klebsiella Pneumoniae

Objective Analysis of K. pneumoniae infection in the Pediatrics and the Neonatology clinical characteristics of the resistance, that can guide and use medicine clinically rationally. Methods The sensitiveness test and ESBL detection to the 20 kinds of antibiotics were examined by Automatic Instrument bacterial identification and susceptibility testing ; ESBL positive strains with the standards disk diffusion method phenotypic confirmatory test. Results The 207 strains of K. pneumoniae from fecal specimens were 77.3% and from respiratory specimens were 18.8%. Imipenem and meropenem sensitivity 100% , followed by compound piperacillin, ciprofloxa- cin, compound amoxicillin and cefoxitin, that sensitive rates were 98% , 97% , 96% and 96% , ;ceftazidime, cefepime, cefotaxime lower sensitivity were 75% ,75% ,78%. 50 ESBL - producing strains, accounting for 24.2%. Conclusions K. pneumoniae have different levels of the drug resistance expcept Imipenem and meropenem, and the multi - drug resistant strains ratio and the positive rate are high. The sensitiveness of penicillin compound containing enzyme inhibitor is second only to the two described above, and they are economy and effective. Considering by medicine economics, the kinds of medicine is preferred on according to the drug sensitivity.