不同标本中大肠埃希菌与肺炎克雷伯菌的耐药分析

目的对襄阳市铁路中心医院不同标本中检出的大肠埃希菌与肺炎克雷伯菌的耐药性进行统计分析,为临床合理用药提供参考。方法针对襄阳市铁路中心医院2011年1月至2012年6月痰、中段尿及分泌物标本中检出的大肠埃希菌与肺炎克雷伯菌的耐药情况进行回顾性分析。结果大肠埃希菌与肺炎克雷伯菌对亚胺培南无耐药菌株出现;其次对哌拉西林/他唑巴坦、头孢哌酮/他唑巴坦和丁胺卡那有较好的敏感性;痰标本中,肺炎克雷伯菌对头孢吡肟和头孢西丁敏感性较好,敏感率分别为74.1%和62.0%。中段尿中检出的大肠埃希菌耐药率略低于痰标本中大肠埃希菌耐药率;痰标本中肺炎克雷伯菌的耐药率略低于中段尿中肺炎克雷伯菌的耐药率;两种菌对其他常用抗菌药物呈较高的耐药性,且为多药耐药。结论大肠埃希菌与肺炎克雷伯菌为临床感染最常见的病原菌,菌株的标本来源不同表现不同的耐药现象,临床上应根据其耐药特点合理选用抗菌药物。

Analysis of the drug resistance of Escherichia coli and Klebsieila pneumonia in different specimens

Objective To investigate theidrug resistance of Escherichia coli and Klebsiella pneumonia in our hospital and to provide reference for rational use of drugs in clinic. Methods The drug resistance of Escherichia coli and Klebsiella pneumonia from the specimens Of sputum, midstream urine and its secretion from January to June in 2012 were analyzed retrospectively. Results First, there was no drug resistant strain to imipenem. Then they had better sensitivity to piperacillin/tazobactam, cefoperazone/tazobactam and arnikacin. In the sputum specimens, Kleb siella pneumonia had good sensitivity to cefepime and cefoxitin （74. ] ~ and 62.0~ ,respectively）. The drug retsistant rate of Escherichia coli checked from the midstream urine was a bit lower than that from the sputum and the secretion specimens. Both of them showed highly drug resistance to other common antibacterial agents, and muhidrug resist-- ant. Conclusion Escherichia coli and Klebsiella pneumonia are the most common pathogenic bacteria, with different drug resistance situation in different specimens. Hospital should use rational antibacterial agents based on its drug resistance.