医学检验与临床
醫學檢驗與臨床
의학검험여림상
MEDICAL LATORATORY SCIENCE AND CLINICES
2014年
5期
47-49,101
,共4页
肺炎克雷伯菌肺炎亚种%耐药率%产超广谱β-内酰胺酶%产碳青霉烯酶(KPC)
肺炎剋雷伯菌肺炎亞種%耐藥率%產超廣譜β-內酰胺酶%產碳青黴烯酶(KPC)
폐염극뢰백균폐염아충%내약솔%산초엄보β-내선알매%산탄청매희매(KPC)
Klebsiella pneumoniae pneumonia subspecies%Drug resistance rate%Extended spectrum beta-lactamase%Klebsiella pneumoniae carbapenemases
目的：探讨我院肺炎克雷伯菌肺炎亚种的耐药情况，以指导临床合理用药。方法：收集本院2013年3月--2014年4月临床标本分离出的108株肺炎克雷伯菌肺炎亚种，使用法国生物-梅里埃ATB Expression半自动细菌鉴定仪及鉴定板条鉴定细菌，使用K-B法检测其对常用的16种抗生素的药敏，用纸片协同试验检测超广谱β-内酰胺酶（ESBLs)，用改良Hoge试验检测产碳青霉烯酶（KPC)。结果：肺炎克雷伯菌肺炎亚种标本主要分布在呼吸系统，对多种常用抗菌药物耐药率高，但对亚胺培南、丁胺卡那、头孢吡肟、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和米诺环素耐药率低，可作为经验用药。108株肺炎克雷伯菌肺炎亚种中，产超广谱β-内酰胺酶（ESBLs)34例（31.5%），12株耐亚胺培南的肺炎克雷伯菌肺炎亚种中，KPC阳性9例（75%）。结论：肺炎克雷伯菌肺炎亚种耐药率高，加强耐药检测，根据药敏实验结果用药对临床有重要作用。
目的：探討我院肺炎剋雷伯菌肺炎亞種的耐藥情況，以指導臨床閤理用藥。方法：收集本院2013年3月--2014年4月臨床標本分離齣的108株肺炎剋雷伯菌肺炎亞種，使用法國生物-梅裏埃ATB Expression半自動細菌鑒定儀及鑒定闆條鑒定細菌，使用K-B法檢測其對常用的16種抗生素的藥敏，用紙片協同試驗檢測超廣譜β-內酰胺酶（ESBLs)，用改良Hoge試驗檢測產碳青黴烯酶（KPC)。結果：肺炎剋雷伯菌肺炎亞種標本主要分佈在呼吸繫統，對多種常用抗菌藥物耐藥率高，但對亞胺培南、丁胺卡那、頭孢吡肟、頭孢哌酮/舒巴坦、哌拉西林/他唑巴坦和米諾環素耐藥率低，可作為經驗用藥。108株肺炎剋雷伯菌肺炎亞種中，產超廣譜β-內酰胺酶（ESBLs)34例（31.5%），12株耐亞胺培南的肺炎剋雷伯菌肺炎亞種中，KPC暘性9例（75%）。結論：肺炎剋雷伯菌肺炎亞種耐藥率高，加彊耐藥檢測，根據藥敏實驗結果用藥對臨床有重要作用。
목적：탐토아원폐염극뢰백균폐염아충적내약정황，이지도림상합리용약。방법：수집본원2013년3월--2014년4월림상표본분리출적108주폐염극뢰백균폐염아충，사용법국생물-매리애ATB Expression반자동세균감정의급감정판조감정세균，사용K-B법검측기대상용적16충항생소적약민，용지편협동시험검측초엄보β-내선알매（ESBLs)，용개량Hoge시험검측산탄청매희매（KPC)。결과：폐염극뢰백균폐염아충표본주요분포재호흡계통，대다충상용항균약물내약솔고，단대아알배남、정알잡나、두포필우、두포고동/서파탄、고랍서림/타서파탄화미낙배소내약솔저，가작위경험용약。108주폐염극뢰백균폐염아충중，산초엄보β-내선알매（ESBLs)34례（31.5%），12주내아알배남적폐염극뢰백균폐염아충중，KPC양성9례（75%）。결론：폐염극뢰백균폐염아충내약솔고，가강내약검측，근거약민실험결과용약대림상유중요작용。
Objective:Discussing the drug resistance of klebsiella pneumoniae pneumonia subspecies in Nanjing Dachang hospital so as to provide information for rational clinical use of drugs.Methods:108 strains klebsiella pneumoniae pneumonia subspecies isolated from clinical specimens in our hospital from March 2013 to April 2014 were collected. They were identified by using the French creatures - French ATB Expression semi-automatic bacteria identification and identification strip of bacteria. At the same time K-B method were used to detect the drug sensitive test of the bacterias for commonly used 16 kinds of antibiotics. Disk diffusion test was used to determined extended spectrum beta-lactamase (ESBLs). Klebsiella pneumoniae carbapenemases(KPC) was determinied by the improved Hoge.Results:The antimicrobial resistance of klebsiella pneumoniae pneumonia subspecies mainly distributed in the respiratory system for a variety of commonly used antibiotics was high, but for imipenem, amikacin, cefepime, cefoperazone/sulbactam, piperacillin/tazobactam, and minocyline was low. so it can be used as clinical use of drugs. Among 108 strains klebsiella pneumoniae pneumonia subspecies, 34 cases were identified to produce extended spectrum beta-lactamase (ESBLs) (31.5%). Among 12 strains klebsiella pneumoniae pneumonia subspecies that were resistant to imipenem, KPC positive were 9 cases (75%).Conclusions:Drug resistance rate of Klebsiella pneumoniae pneumonia subspecies was high. So strengthening drug test and clinical medication according to the results of the clinical drug susceptibility test have an important role.
