摘要
目的探讨医院内感染与社区感染儿童肺炎克雷伯杆菌(KP)的临床特点,并对其耐药性作简要分析。方法收集广西医科大学第四附属医院2009年1月至2012年12月收治的经痰液细菌培养确定为KP的肺炎患儿79例,分为院内感染组(11例)和社区感染组(68例),记录患儿临床信息,对痰液细菌作药敏试验并检测超广谱β-内酰胺酶。结果院内感染组检出超广谱β-内酰胺酶阳性菌株10例(90.9%,9/11),对头孢唑啉、氨苄西林/舒巴坦、青霉素类、头孢曲松、氨曲南、头孢吡肟和头孢他啶等药物产生高度耐药,对环丙沙星、头孢替坦和哌拉西林/三唑巴坦等药物敏感。社区感染组共检出超广谱β-内酰胺酶阳性菌株12例(17.6%,12/68),对青霉素类药物产生高度耐药,而对于其他类型抗菌药物未产生明显耐药性。结论超广谱β-内酰胺酶阳性的KP感染肺炎的多重耐药性问题较为严重,应引起重视,在治疗上医院内感染和社区感染患儿在抗菌药物的选用上应区别对待。
Objective To investigate clinical characteristics of children infected with Klebsiella pneumonia （KP） in community and nosocomial ,and analysis briefly about their resistance .Methods 79 cases of children with pneumonia identified as KP infection by the method of sputum bacterial culture were collected and divided into nosocomial infection group （11 cases） and community in-fection group（68 cases） from January 2009 to December 2012 .The clinical information were recorded ,sputum bacterial susceptibili-ty and extended-spectrum β-lactamase enzyme were tested .Results 10 cases and 12 cases of extended-spectrumβ-lactamase enzyme strains were detected from nosocomial infection group and community infection group ,respectively .The children infected KP had a high degree of resistance to cefazolin ,ampicillin/sulbactam ,head penicillin ,ceftriaxone ,aztreonam ,cefepime and ceftazidime ,while sensitive to ciprofloxacin ,cefotetan and piperacillin/tazobactam in the nosocomial infection group .12 cases in community infection group produce highly resistant to penicillin-type drugs ,but were not obvious resistance to other types of antibiotics .Conclusion Multi-drug resistance problems are serious in the pneumonia children who infected KP and the extended-spectrum β-lactamase en-zyme is positive .Infected children should be treated differently in the selection of antibiotics in the treatment of infection in commu-nity and nosocomial .
出处
《重庆医学》
CAS
CSCD
北大核心
2013年第36期4382-4384,共3页
Chongqing medicine
基金
国家自然科学基金资助项目(81070004)
