住院肝病患者肺部感染肺炎克雷伯菌及其耐药性分析

发布时间：2017-12-31 08:28

本文关键词：住院肝病患者肺部感染肺炎克雷伯菌及其耐药性分析　出处：《中国消毒学杂志》2016年09期 　论文类型：期刊论文

【摘要】：目的了解住院肝病患者肺部感染肺炎克雷伯菌及其耐药情况,为临床合理应用抗菌药物提供依据。方法通过细菌分离鉴定和药敏试验方法,对山东某传染病专科医院住院肝病患者送检痰标本进行病原菌检测和分析。结果从65例住院肝病并发肺部感染患者痰标本中分离出65株肺炎克雷伯菌,其中检出产超广谱β-内酰胺酶菌株(ESBLs)21株,占32.31%。从痰液分离的肺炎克雷伯菌对18种临床常用抗菌药物均不同程度耐药,产ESBLs菌株耐药率明显高于非ESBLs菌株。临床分离的肺炎克雷伯菌仅对亚胺培南/西司他丁和美罗培南等碳青霉烯类比较敏感。结论住院肝病患者肺部感染的肺炎克雷伯菌中产ESBLs菌株比例较高,耐药严重,仅对碳青霉烯类抗菌药物敏感,提示应根据药敏试验结果选用抗菌药物。
[Abstract]:Objective to understand the situation of Klebsiella pneumoniae and its drug resistance in hospitalized patients with liver disease, and to provide evidence for the rational use of antimicrobial agents in clinic. Results 65 strains of Klebsiella pneumoniae were isolated from the sputum samples of 65 hospitalized patients with pulmonary infection. Among them, 21 strains (32.31%) produced extended-spectrum 尾 -lactamases (ESBLsN). Klebsiella pneumoniae isolated from sputum were resistant to 18 kinds of commonly used antibiotics in different degrees. The drug resistance rate of ESBLs producing strains was significantly higher than that of non-#en1# strains. Klebsiella pneumoniae isolated clinically was only sensitive to carbapenem such as imipenem / cilastatin and meropenem. Conclusion inpatients with liver diseases are more sensitive to carbapenem. The proportion of ESBLs producing strains of Klebsiella pneumoniae in pulmonary infection was higher. The drug resistance is serious and only sensitive to carbapenes, suggesting that antimicrobial agents should be selected according to the results of drug sensitivity test.
【作者单位】：山东大学附属济南市传染病医院;
【分类号】：R575
【正文快照】： 失代偿期肝硬化、肝功能衰竭等肝病末期患者机体免疫力降低,易并发医院感染,肺部感染是其最严重的并发症之一,可直接或间接加重肝损害或诱发其他严重并发症,病死率更高〔1〕。肺炎克雷伯菌是导致肝病患者并发肺部感染最常见的病原菌之一,由于该菌耐药性严重,一旦发生肺部感染

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