安徽省809株肺炎克雷伯菌感染的临床分布、耐药性与基因型分析

发布时间：2018-06-07 05:46

本文选题：肺炎克雷伯菌 + 药物敏感性　；参考：《中国抗生素杂志》2016年06期

【摘要】：目的了解安徽省2013年与2014年肺炎克雷伯菌感染的临床分布及耐药情况,为临床合理使用抗菌药物药供参考依据。方法收集安徽省内35所医院送检的临床标本,从中分离出肺炎克雷伯菌株,采用琼脂倍比稀释法进行抗菌药物敏感性测定,用WHONET 5.6和SPSS l7.0软件对肺炎克雷伯菌的来源、耐药率及其变化情况进行统计分析。结果 2013—2014年共分离出肺炎克雷伯菌809株,其中来源于ICU的标本中的检出率最高,平均检出率为30.7%。绝大部分菌株分离于痰液标本,占总菌株的57.8%。两年的菌株产ESBLs菌株的检出率分别为32.5%和38.9%,多重耐药检出率分别为37.2%和40.9%。药物敏感试验结果显示:在所有进行检测的抗菌药物里,碳青霉烯类药物的耐药率最低;耐药率最高的药物为氨苄西林,分别为55.4%和63.4%。产ESBLs的肺炎克雷伯菌菌株对多种类抗菌药物的耐药率均高于非产ESBLs菌株。282株产ESBLs肺炎克雷伯菌中,97株细菌携带blaCTX-M-14基因。结论临床标本分离出肺炎克雷伯菌株较多,CTX-M-14型超广谱β-内酰胺酶为主要的耐药机制,因此该菌株对临床常用的各类抗菌药物呈现出不同程度的耐药;治疗上可优先选用含酶抑制剂的复合制剂或碳青霉烯类药物。加强细菌的耐药性监测与防控,有利于临床合理使用抗菌药物。
[Abstract]:Objective to investigate the clinical distribution and drug resistance of Klebsiella pneumoniae infection in Anhui Province in 2013 and 2014 so as to provide reference for rational use of antimicrobial agents. Methods Klebsiella pneumoniae was isolated from clinical specimens from 35 hospitals in Anhui Province. The antimicrobial susceptibility of Klebsiella pneumoniae was determined by Agar doubling dilution method. The origin of Klebsiella pneumoniae was detected by WHONET 5.6 and SPSS L7.0 software. Drug resistance rate and its changes were statistically analyzed. Results A total of 809 strains of Klebsiella pneumoniae were isolated from 2013 to 2014. The detection rate of Klebsiella pneumoniae from ICU samples was the highest, with an average detection rate of 30.7%. Most of the strains were isolated from sputum, accounting for 57.8% of the total strains. The detection rates of ESBLs producing strains were 32.5% and 38.9%, and the detection rates of multidrug resistance were 37.2% and 40.9%, respectively. The results of drug sensitivity test showed that the resistance rate of carbapenem was the lowest, and ampicillin was the highest, which was 55.4% and 63.4%, respectively. The resistance rate of Klebsiella pneumoniae producing ESBLs to many kinds of antimicrobial agents was higher than that of non-producing ESBLs strain. 282 strains of Klebsiella pneumoniae produced ESBLs. 97 strains of Klebsiella pneumoniae were carrying blaCTX-M-14 gene. Conclusion the strains of Klebsiella pneumoniae isolated from clinical samples were mainly resistant to extended-spectrum 尾 -lactamases of CTX-M-14 type, so the strains showed different degrees of resistance to various antimicrobial agents commonly used in clinic. The combination of enzyme inhibitors or carbapenems can be used in treatment. Strengthening the surveillance and prevention of bacterial resistance is beneficial to the rational use of antimicrobial agents in clinic.
【作者单位】：安徽医科大学第一附属医院感染病科;安徽省细菌耐药性监控中心;
【分类号】：R440

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