现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2014年
17期
2598-2599,2614
,共3页
克雷伯菌,肺炎%抗菌药%药物耐受性%β内酰胺酶类
剋雷伯菌,肺炎%抗菌藥%藥物耐受性%β內酰胺酶類
극뢰백균,폐염%항균약%약물내수성%β내선알매류
Klebsiella pneumoniae%Anti-bacterial agents%Drug tolerance%Beta-lactamases
目的：探讨肺炎克雷伯菌的临床分布及对抗菌药物的耐药情况，为临床合理选用抗菌药物提供参考。方法收集2008年1月至2011年12月该院住院患者各类标本中分离的肺炎克雷伯菌428株，对其临床分布及药敏试验结果进行回顾性分析。结果428株肺炎克雷伯菌中产超广谱β-内酰胺酶（ESBLs）菌183株（42.76％）。药敏试验结果显示，产ESBLs肺炎克雷伯菌对亚胺培南、阿米卡星、哌拉西林/他唑巴坦耐药率较低，分别为0.00%（0/183）、12.02%（22/183）和18.03%（33/183）；对头孢菌素类和单环β-酰胺类抗菌药物呈现高度耐药性；对氨基糖苷类、氟喹诺酮类、磺胺类抗菌药也存在较高耐药性，其中喹诺酮类的耐药率变化最为显著。结论肺炎克雷伯菌耐药现象严重，特别是产ESBLs肺炎克雷伯菌，临床医生应根据药敏试验结果并结合临床感染情况合理使用抗菌药物，有效控制耐药菌的产生，避免耐药菌株的传播。
目的：探討肺炎剋雷伯菌的臨床分佈及對抗菌藥物的耐藥情況，為臨床閤理選用抗菌藥物提供參攷。方法收集2008年1月至2011年12月該院住院患者各類標本中分離的肺炎剋雷伯菌428株，對其臨床分佈及藥敏試驗結果進行迴顧性分析。結果428株肺炎剋雷伯菌中產超廣譜β-內酰胺酶（ESBLs）菌183株（42.76％）。藥敏試驗結果顯示，產ESBLs肺炎剋雷伯菌對亞胺培南、阿米卡星、哌拉西林/他唑巴坦耐藥率較低，分彆為0.00%（0/183）、12.02%（22/183）和18.03%（33/183）；對頭孢菌素類和單環β-酰胺類抗菌藥物呈現高度耐藥性；對氨基糖苷類、氟喹諾酮類、磺胺類抗菌藥也存在較高耐藥性，其中喹諾酮類的耐藥率變化最為顯著。結論肺炎剋雷伯菌耐藥現象嚴重，特彆是產ESBLs肺炎剋雷伯菌，臨床醫生應根據藥敏試驗結果併結閤臨床感染情況閤理使用抗菌藥物，有效控製耐藥菌的產生，避免耐藥菌株的傳播。
목적：탐토폐염극뢰백균적림상분포급대항균약물적내약정황，위림상합리선용항균약물제공삼고。방법수집2008년1월지2011년12월해원주원환자각류표본중분리적폐염극뢰백균428주，대기림상분포급약민시험결과진행회고성분석。결과428주폐염극뢰백균중산초엄보β-내선알매（ESBLs）균183주（42.76％）。약민시험결과현시，산ESBLs폐염극뢰백균대아알배남、아미잡성、고랍서림/타서파탄내약솔교저，분별위0.00%（0/183）、12.02%（22/183）화18.03%（33/183）；대두포균소류화단배β-선알류항균약물정현고도내약성；대안기당감류、불규낙동류、광알류항균약야존재교고내약성，기중규낙동류적내약솔변화최위현저。결론폐염극뢰백균내약현상엄중，특별시산ESBLs폐염극뢰백균，림상의생응근거약민시험결과병결합림상감염정황합리사용항균약물，유효공제내약균적산생，피면내약균주적전파。
Objective To investigate the clinical distribution and drug resistance to antibacterials of Klebsiella pneumo-niae,in order to provide clinical reference for rational use of antibacterial agents. Methods A total of 428 strains of Klebsiella pneumonia,which were isolated from inpatients from January 2008 to December 2011 in the hospital,were collected and analyzed retrospectively on clinical distribution and results of drug susceptibility test. Results In 428 strains,183 strains were extended-spectrum-beta-1actamases (ESBLs)-producing Klebsiella pneumoniae (42.76%). Drug susceptibility test results showed that the drug resistance rates of ESBLs-producing Klebsiella pneumonia to imipenem,amikacin,piperacillin/tazobactam were 0.00%(0/183), 12.02%(22/183) and 18.03%(33/183) respectively;it had high drug-resistance to cephalosporins and monocyclicβ-lactam an-tibacterial agents;and the drug resistance to aminoglycoside,fluoroquinolone,sulfonamide was relatively high,especially the re-sistance rate changes of quinolones was the most significant. Conclusion The drug resistance of Klebsiella pneumonia is seri-ous,especially the ESBLs-producing Klebsiella pneumonia,so the clinicians should make rational use of antibacterial agents based on susceptibility test results,combining with clinical infection,to control the generation of drug-resistance bacteria effec-tively and avoid the dissemination of drug-resistant strains.
