摘要
目的了解2011年中国CHINET所属15所医院临床分离的克雷伯菌属细菌的耐药情况。方法采用纸片扩散法(K-B法)和自动化仪器对临床分离株作药敏试验,并按CLSI 2011年版标准判断药敏试验结果。结果共收集中国CHINET细菌耐药性监测网15所医院分离的肺炎克雷伯菌6 390株、产酸克雷伯菌547株、肺炎克雷伯菌臭鼻亚种42株和其他克雷伯菌属细菌2株,其中儿童及青少年(0～17岁)来源的克雷伯菌属细菌占19.3%(1 346/6 981)。56.3%分离株来源于呼吸道标本。药敏试验结果显示,克雷伯菌属细菌对亚胺培南、美罗培南和厄他培南3种碳青霉烯类抗生素的耐药率分别为9.3%、9.4%和11.3%,对头孢哌酮-舒巴坦和哌拉西林-他唑巴坦的耐药率分别为15.8%和15.9%。15所医院均分离出对碳青霉烯类抗生素(亚胺培南或美罗培南)耐药菌株,其中肺炎克雷伯菌642株,产酸克雷伯菌33株。结论克雷伯菌属细菌对碳青霉烯类抗生素、头孢哌酮-舒巴坦和哌拉西林-他唑巴坦仍保持高度敏感性,按CLSI 2011年版新标准,对碳青霉烯类抗生素耐药菌株的分离率已近10.0%,且耐药株仍主要集中于华东地区,加强医院感染控制至关重要。
Objective To investigate the antimicrobial resist- ance in the clinical Klebsiella strains isolated from the 15 hospitals participating in China CHINET in 2011. Methods Disc diffusion technique （Kirby-Bauer method） and automat- ic microbiology analysis system were employed to determine the antimicrobial resistance. WHONET 5 . 6 software was used for analysis according to Clinical and Laboratory Stand- ards Institute （CLSI） 2011 breakpoints. Results A total of 6 98l clinical isolates of Klebsiella spp. were analyzed in 2011, including K. pneumoniae （6 390）, K. oxytoca （547）, Kleb siella pneumoniae subsp. Ozaenae （42） and other Klebsiella species （2）. About 19.3% （1 346/6 981） of the Klebsiella strains were isolated from children or adolescence （0 18 years of age）. According to the antimicrobial susceptibility test, all the isolates showed the lowest resistance rate to imipenem （9.3%）, meropenem （9.4%） and ertapenem （11.3%）, followed by cefopera zone-sulbactam （15.8%） and piperacillin-tazobaetam （15.9%）. A total of 642 K. pneumoniae strains and 33 K. oxytoca strains were identified as resitant to either imipenem or meropenem among all the isolates from 15 hospitals. Conclusions Clinical Kleb- siella spp. isolates demonstrate lower resistance to carbapenems, cefoperazone-sulbactam and piperacillin tazobactam. The preva lence of earbapenem-resistant Klebsiella strains is still increasing in China, nearly 10.0% in 2011, especially in Eastern China. It is critical to make every effort to control hospital infections.
出处
《中国感染与化疗杂志》
CAS
北大核心
2013年第5期331-336,共6页
Chinese Journal of Infection and Chemotherapy
关键词
克雷伯菌属
耐药性监测
药敏试验
Klebsiella spp.
resistance surveillance
susceptibility testing
