肺炎克雷伯菌肺炎耐药性检测与分析

目的监测肺炎克雷伯杆菌肺炎耐药性、ESBLs的产生及其对常用抗生素的耐药性.方法由深圳市武警医院1999～2002年住院的肺炎克雷伯菌肺炎患者分离所得118株肺炎克雷伯杆菌,采用标准纸片扩散确证法检测其ESBLs产生率,采用K-B法进行药敏监测.结果肺炎克雷伯菌肺炎中产ESBLs率为35%,产ESBLs株耐药性显著高于非产ESBLs株.产ESBLs株仅对四代头孢菌素、三代头孢菌素与β-内酰胺酶抑制剂复合物、亚胺培南敏感,亚胺培南仍然为最有效的抗生素.产ESBLs株感染为致死的重要原因.结论近年来克雷伯杆菌产ESBLs率显著升高;亚胺培南仍然为最有效的抗生素;产ESBLs株感染为肺炎克雷伯菌肺炎致死的重要原因,应采取措施控制产ESBLs克雷伯杆菌感染.

Study on drug resistance of klebsiella pneumoniae pneumonia

Objective To determine the antibiotic resistance and the productive rate of extended-spectrum-beta-lactamase (ESBLs) of Klebsiella pneumoniae pneumonia.Methods One hundred eighteen strains of Klebsiella pneumoniae were isolated from Klebsiella pneumoniae pneumonia patients admitted to the Shenzhen Armed Police Hospital during 1999 to 2002,then antibiotic susceptibility test was peformed by Kirby-Baucer disk diffusion assay.ESBLs production was performed by the standard disk diffusion method.Results ESBLs productive rate was 35% from Klebsiella pneumoniae pneumonia patients.ESBLs-producing strains had higher drug-resistance than No-ESBLs-producing strains.ESBLs-producing strains were only sensitive to the combination of third-generation cephalosporins and beta-lactase inhibitor,fourth-generation cephalosporins and imipenem.Imipenem had the most effective antibiotic activity among them.ESBLs-producing strains infection was the main lethal cause of Klebsiella pneumoniae pneumonia.Conclusion ESBLs production of Klebsiella pneumoniae pneumonia had significantly increased.ESBLs-producing strains was most senstive to Imipenem.ESBLs-producing strains infection was the main lethal cause.Measures should be taken to control the infection of ESBLs-producing strains.