肺炎克雷伯菌的分布与药敏性分析

目的 统计2009-2010年肺炎克雷伯菌的分布、药敏性及流行状况,指导临床用药,控制医院感染.方法 对2010年分离出肺炎克雷伯菌的162例住院患者进行标本、科室分布的统计及药敏分析；对其中多药耐药肺炎克雷伯菌作ESBLs、AmpC酶、碳青霉烯酶、新德里金属β-内酰胺酶(NDM)-1等试验.结果 162株肺炎克雷伯菌主要来自痰液,占76.54％,其次为尿液及伤口分泌物,分别占8.64％、6.79％；主要分布于ICU、呼吸内科,分别占51.23％、22.84％；产ESBLs肺炎克雷伯菌检出84株,检出率为51.85％,产AmpC酶检出20株,检出率为12.355％,产KPC酶检出17株,检出率为10.49％,没有检测到产新德里金属β-内酰胺酶(NDM)-1菌株.结论 肺炎克雷伯菌耐药率比较高并且耐药因子多样,对多药耐药肺炎克雷伯菌有必要进行耐药机制的检测,以便控制医院感染.

Analysis of drug resistance and prevalence of Klebsiella pneumoniae strains isolated from hospitalized patients

OBJECTIVE To analyze distribution,drug susceptibility and prevalence of Klebsiella pneumoniae during 2009-2010,so as to guide the clinical application of medicine and control nosocomial infection.METHODS A total of 162 strains of K.pneumoniae isolated from inpatients in 2010 were collected,the specimen department distribution and drug sensitivity were analyzed;ESBLs,AMPC enzyme,carbapenemase and NDM-1 enzymes tests were carried out with multidrug-resistant K.pneumoniae strains.RESULTS Majority of the 162 strains of K.pneumoniae were isolated from sputum,accounting for 76.54%,followed by urine and wound secretions,accounting for 8.64% and 6.79% respectively.The strains were mainly distributed in ICU and respiratory medicine department,accounting for 51.23% and 22.84%,respectively.84 strains producing ESBLs enzyme were detected,with detection rate of 51.85%.20 strains of K.pneumoniae producing AMPC enzyme were detected,with detection rate of 12.35%.17 strains producing KPC enzyme were detected,with detection rate of 10.49%.There was no strain producing NDM-1 enzyme.CONCLUSION The resistance rate of K.pneumoniae is relatively high and there are various resistance factors.It is necessary to test drug-resistant mechanism of multidrug-resistant K.pneumoniaen which will benefit to the prevention and control of nosocomial infection.