血流感染中肺炎克雷伯菌的分布及耐药性分析

目的了解患者血流感染中分离的肺炎克雷伯菌分布及耐药特征,以指导临床合理使用抗菌药物。方法回顾性调查南昌大学第一附属医院2014年1月至12月分离自患者血流感染中肺炎克雷伯菌的分布和耐药特性。采用K-B法进行药敏试验,依据2011年CLSI标准判读结果。采用SPSS 17.0软件分析数据。结果共获得肺炎克雷伯菌79株,以消化内科病房多见,占48.1%(38/79),患者年龄50岁者占67.1%(53/79),对头孢哌酮/舒巴坦耐药率最低,为11.4%。结论患者免疫功能低下是肺炎克雷伯菌感染的主要原因,血流感染中分离的肺炎克雷伯菌耐药非常严重,头孢哌酮/舒巴坦可作为经验用药之一。

Distribution and antibiotic resistance analysis of the Klebsiella pneumonia strains in infected bloodstream

Objective To investigate the distribution and antimicrobial resistance pattern of the Klebsiella pneumonia (K. pneumonia) strains in bloodstream,and guide for rational use of antimicrobial agents. Methods A retrospective review was con-ducted to analyze the Klebsiella pneumonia strains in infected bloodstream from January 2014 to December in the First Affiliated Hospital of Nanchang University in terms of clinical department,patient age,specimen source and antibiotic resistance. Antimicro-bial susceptibility testing was carried out by Kirby-Bauer method. The results were interpreted according to the breakpoints of CLSI 2011. All data were analyzed with SPSS 17.0 software. Results A total of 79 K pneumonia strains were isolated from infect-ed bloodstream,38(48.1%) strains of which were collected from patients in the Department of Digestive System,53(67.1%) strains from elderly patients (50 years of age or older). The resistant rate to cefoperazone-sulbactam was 11.4%,which was the least one. Conclusions Compromised immune function is the major cause for K. pneumonia infection. It is a serious issue to isolate multi-drug resistant K. pneumonia from infected bloodstream. It is reasonable to consider cefoperazone-sulbactam as one of the options in empirical treatment.