肺炎克雷伯菌的分布及耐药性分析

发布时间：2018-01-04 12:16

本文关键词：肺炎克雷伯菌的分布及耐药性分析　出处：《中国感染与化疗杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的调查广西医科大学第一附属医院临床分离肺炎克雷伯菌的科室分布与耐药特点,为肺炎克雷伯菌感染治疗提供抗菌药物选择理论依据。方法收集2015年1-12月住院患者分离的非重复肺炎克雷伯菌,采用VITEK 2-Compact60自动分析仪与纸片扩散法进行菌种鉴定及药敏分析,对其标本类型、科室分布及常用22种抗菌药物药敏结果进行统计分析。结果获取非重复分离的肺炎克雷伯菌753株,痰液标本检出最多,308株,占40.9%;其次尿液137株,占18.2%;分离自年龄60岁患者菌株307株,占40.8%;检出率高的科室前2位的是ICU和呼吸内科,分别为126株(16.7%)和103株(13.7%);同期以呼吸系统感染收治入院者144例,分离得肺炎克雷伯菌103株,该菌感染率71.5%。肺炎克雷伯菌株对哌拉西林、头孢唑林和头孢呋辛耐药率分别为66.3%、60.8%和59.4%,对亚胺培南与美罗培南耐药率分别为2.4%与2.0%;产ESBL肺炎克雷伯菌410株(54.4%),耐碳青霉烯类菌株29株(3.9%);多重耐药(MDR)菌株492株(65.3%)。结论该院肺炎克雷伯菌耐药严重,其主要分离自痰液、尿液标本,ESBL阳性菌株与MDR菌株检出率均较高,医院需加强对肺炎克雷伯菌感染者的目标性监测,控制MDR肺炎克雷伯菌在医院内的流行。
[Abstract]:Investigation of Distribution Department the First Affiliated Hospital of Guangxi Medical University of clinical isolates of Klebsiella pneumoniae and drug resistance to infection, provide the theoretical basis for the selection of antimicrobial treatment of Klebsiella pneumoniae. Methods from 2015 1-12 month of hospitalized patients with isolated non repeated Klebsiella pneumoniae, using VITEK 2-Compact60 automatic analyzer and disk diffusion method for species identification and drug sensitivity analysis, the specimen type, distribution departments and 22 kinds of commonly used antimicrobial drug sensitivity results were analyzed. The results obtained non duplicate isolates of 753 strains of Klebsiella pneumoniae, sputum samples detected most, 308 strains, accounting for 40.9%; secondly, the urine of 137 strains, accounting for 18.2%; from age 60 patients 307 strains, accounting for 40.8%; the detection rate of high section 2 is ICU and respiratory medicine, respectively, 126 strains (16.7%) and 103 strains (13.7%); 144 cases with respiratory infection treated patients, divided From 103 strains of Klebsiella pneumoniae, piperacillin 71.5%. rate of Klebsiella pneumoniae strains of the bacteria infection, cefazolin and cefuroxime resistance rates were 66.3%, 60.8% and 59.4%, to imipenem and meropenem resistance rates were 2.4% and 2%; ESBL producing Klebsiella pneumoniae 410 strains (54.4%). Carbapenem resistance in 29 strains (3.9%); multidrug resistance (MDR) of 492 strains (65.3%). Conclusions the Klebsiella pneumoniae is serious, which mainly isolated from sputum, urine samples, ESBL positive strains and MDR strains have high detection rates, hospitals need to strengthen surveillance of infection pneumonia Klebsiella pneumoniae and the control MDR of Klebsiella pneumoniae in nosocomial epidemic.

【作者单位】：广西医科大学第一附属医院检验科;广西医科大学第一附属医院药学部;广西医科大学第一附属医院医院感染管理科;
【基金】：广西中医药自筹课题(GZZC13-15)
【分类号】：R446.5
【正文快照】： 作者单位:广西医科大学第一附属医院检验科;南宁530021;*药学部,**医院感染管理科。覃金球,丘岳*,郭世辉**,李萌,林发全,万瑞融*,温燕*肺炎克雷伯菌是引起临床机会性感染较为常见的条件致病菌,主要存在于人体上呼吸道与肠道,具有多种耐药机制,可引起医院感染暴发流行。全国细

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