Changes of drug resistance of 1 939 strains of clinical isolated Klebsiella pneumoniae in a hospital of Traditional Chinese Medicine
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摘要: 目的 分析2013—2015年某中医院临床标本中分离的肺炎克雷伯菌耐药率,为临床抗感染治疗及医院感染控制提供依据。 方法 对某中医院2013—2015年临床送检标本中分离的肺炎克雷伯菌,采用纸片扩散法(K-B法)和MIC法测定其对抗菌药物的敏感性,使用WHONET 5.6软件对结果进行分析。 结果 共分离出肺炎克雷伯菌1 939株,主要来源于痰(72.98%)、尿(12.74%)和血液(4.74%)。呼吸科(15.58%)、老年科(10.83%)、肾内科(7.43%)、ICU (6.45%)是检出肺炎克雷伯菌最多的科室。肺炎克雷伯菌对哌拉西林耐药率最高(36.62%),对头孢呋辛、头孢噻肟、头孢曲松、复方新诺明以及氨苄西林/舒巴坦的耐药率均>30%;对碳青霉烯类、含β-内酰胺酶抑制剂的复方制剂耐药率较低(<15%)。肺炎克雷伯菌对亚胺培南连续3年的耐药率分别是10.30%、9.75%和11.81%;对美罗培南耐药率分别为10.41%、10.00%、10.94%。 结论 该中医院内肺炎克雷伯菌对二、三代头孢耐药率高,对碳青霉烯类耐药率有上升趋势。需合理使用抗菌药物,谨慎选择碳青霉烯类药物,减少多重耐药菌产生。Abstract: Objective To study the distributions and drug resistance of clinical isolated K.pneumoniae from a hospital of Traditional Chinese Medicine(TCM),and provide scientific evidence for anti-infective therapy and nosocomial infection control. Methods The K.pneumoniae strains were isolated from clinical specimens between January,2013 and December,2015 in a hospital of TCM.The drug sensitivity test was performed by using K-B method and MIC method,and all of data was analyzed by using WHONET 5.6 software. Results A total of 1 939 strains of K.pneumoniae were isolated from clinical specimens.The top three clinical specimens were sputum(72.98%),urine(12.74%) and blood(4.74%).Department of Respiratory(15.58%),Department of Gerontology(10.83%),Nephrology Department(7.43%) and ICU(6.45%)accounted for the highest proportion.The drug resistance rates of K.pneumoniae to piperacillin were highest(36.62%),and the rates to cefuroxime,cefotaxime,ceftriaxon,SMZ-TMP and ampicillin/sulbactam were all more than 30%.The resistance to carbapenem and β-lactamase inhibitor compound were less than 15%.The resistant rates to imipenem were 10.30%,9.70% and 11.81% respectively in recent 3 years,and to Meropenem were10.41%,10.00% and 10.94%,respectively. Conclusion Klebsiella pneumoniae isolated from this hospital of TCM shows a elevated resistance rates to second and third generation cephalosporins,and the resistance rates to carbapenems have a trend of escalation.To reduce the production of multi-drug resistant bacteria,antibiotics,especially carbapenems,should be used cautiously and rationally.
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Key words:
- Klebsiella pneumoniae /
- Drug resistance /
- Carbapenems
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