摘要
目的了解重庆地区儿童2011-2013年肺炎克雷伯菌的临床分布特征及耐药性,为合理应用抗菌药物和预防控制医院交叉感染提供依据。方法分析我院2011-2013年临床标本分离出的5 500株肺炎克雷伯菌对18种抗菌药物的耐药性,采用BD Phoenix 100 MIC法结合K-B纸片扩散法进行药敏试验,按美国临床实验室标准化委员会(CLSI)标准判断结果。结果共分离肺炎克雷伯菌5 500株,以痰标本多见,占84.9%(4 668株);其在不同病房中以新生儿科病房分布最高,其次为呼吸病房,分别为30.4%和23.0%。肺炎克雷伯菌对阿米卡星的耐药率最低,仅为2.5%,美罗培南、左旋氧氟沙星、亚胺硫霉素耐药率分别为3.5%、3.6%、3.8%。2011-2013年肺炎克雷伯菌对亚胺硫霉素、左旋氧氟沙星、阿米卡星、环丙沙星、氯霉素、美罗培南的耐药率无明显改变(P>0.05),其余受试药物的耐药率均有明显改变(P<0.05)。超广谱β-内酰胺酶(ESBLs)检出率为33.2%(1 828株),2011-2013年ESBLs检出率有明显改变(P<0.0001)。结论肺炎克雷伯菌的耐药性呈上升趋势,新生儿科是本院预防控制的重点科室。
Objective To investigate the distribution and antibiotic resistance of Klebsiella pneumonia isolated from children in Chongqing during Jan 2011 to Dec 2013, and provide evidence for reasonable use of antibiotics and prevention and and control of cross infections. Methods Identification and antibiotic susceptibility tests （AST） were performed on the total 5,500 Klebsiella pneumonia isolates by BD Phoenix 100 automated system and the conven- tional Kirby-Bauer method. The AST results were interpreted according to the guidelines of the Clinical and Laboratory Standards Institute （CLSI）. Results Of the 5,500 strains of Klebsiella pneumonia, 4,668 strains （84. 9% ） were isolated from sputum. The distribution of Klebsiella pneumonia in neonatology ward was the highest （30. 4% ） among different wards, followed by respiratory ward, 23%. The susceptibility of Klebsiella pneumonia strains was 2. 5% to Amikacin, 3.5% to Meropenem, 3.6% to Levofloxacin, and 3.8% to Imipenem. The susceptibility rates to Ampicillin, Imipenem, Levofloxacin, Amikacin, Ciprofloxacin, Chloramphenicol and Meropenem showed no significant changes from 2011 to 2013 （P 〉 0. 05 ）. However, the resistance rates to the other antibiotics changed with statistical significance （P 〈 0. 05 ）. A total of 1,828 ESBLs were isolated, accounting for 33.2%, and the change was significant from 2011 to 2013 （P 〈 0. 0001 ）. Conclusion The drug resistance of Klebsiella pneumonia tends to increase. The prevention and control of nosocomial infections should focused on the neonatology department.
出处
《中国微生态学杂志》
CAS
CSCD
2015年第3期301-304,309,共5页
Chinese Journal of Microecology
基金
重庆市卫生局医学科研基金资助项目(渝卫科教[2010]51号2010-2-167)
关键词
交叉感染
肺炎克雷伯菌
耐药性
儿童
Cross infection
Klebsiella pneumonia
Antibiotic resistance
Children
作者简介
赵洁（1981-），女，技师，本科，从事细菌耐药方面的研究，Email：22133429@qq．com
通讯作者：景春梅（1979-），女，主管技师，硕士，从事细菌耐药和细菌致病机制方面的研究，Email：444524718@qq．com
