肺炎克雷伯菌下呼吸道感染的耐药性及基因分型研究

目的 了解肺炎克雷伯菌下呼吸道感染株的耐药现状，监测耐药株的流行趋势。方法 采用微量稀释法对86株引起下呼吸道感染的肺炎克雷伯菌进行抗生素药敏试验和超广谱β－内酰胺酶（ESBLs)检测，并对产ESBLs菌株以随机扩增多态性DNA（RAPD）法进行基因分型。结果 产ESBLs肺炎克雷伯菌占20．9％，其中83．3％来源于呼吸科重症监护病房（RICU）。ESBLs阳性菌对10种抗生素的耐药性远远高于ESBLs阴性菌，并同时高耐氨基糖苷类、喹诺酮类抗生素。18株产ESBLs肺炎克雷伯菌分为12型。其中3株属于A型，5株属于B型，其它为不同类型。结论 RICU病房有产ESBLs肺炎克雷伯菌分为12型。其中3株属于A型，5株属于B型，其它为不同类型。结论 RICU病房有产ESBLs肺炎克雷伯菌同一克隆株集中分布，提示流行可能。

Drug resistance and genotyping of Klebsiella pneumoniae in lower respiratory tract infection

Objective To understand the current drug resistance of Klebsiella pneumoniae in lower respiratory tract infection and the prevalence trend of extended spectrum beta lactamase (ESBLs) producing Klebsiella pneumoniae Methods Drug resistance in 86 strains of Klebsiella pneumoniae and ESBLs producing strains were genotyped by randomly amplified DNA polymorphisms (RAPD) Results ESBLs producing strains accounted for 20 9% of the 86 strains, and 83 3% of the ESBLs producing strains were from respiratory ICU The drug resistance rate of ESBLs positive bacteria was much higher than that of ESBLs negative bacteria ESBLs positive bacteria were resistant to both the quinolones and a minoglylosides Eighteen ESBLs producing strains were divided into 12 types 3 strains had the same profile (genotype A), and 5 strains had an identical profile (genotype B), but other strains had different profiles Conclusions Chromosomal DNA analysis proved that certain types of ESBLs producing Klebsiella pneumoniae were epidemic in respiratory ICU.RAPD was an economic, simple but reliable method in epidemic study