摘要
目的了解医院2006-2015年临床分离的肺炎克雷伯菌分布和耐药性变迁,为临床合理使用抗菌药物提供参考。方法回顾性分析2006-2015年医院门诊、急诊和住院患者中分离的肺炎克雷伯菌,对其细菌分布及药物敏感性进行分析。结果 2006-2015年共分离出肺炎克雷伯菌7442株,96.86%菌株分离自住院患者,52.14%菌株分离自痰标本;肺炎克雷伯菌对抗菌药物的耐药性呈整体上升趋势;产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌的检出率约60.00%;肺炎克雷伯菌对头孢哌酮/舒巴坦、头孢他啶和氨曲南的耐药率分别由2.20%、20.10%、17.30%上升至27.40%、41.60%、48.60%,上升明显;ICU科分离的肺炎克雷伯菌耐药率最高,其次为儿科、外科和内科。结论医院分离的肺炎克雷伯菌耐药情况非常严峻,分离自不同年龄段和科室的菌株对抗菌药物的耐药性相差较大,必须加强抗菌药物管理,继续开展病原菌分布及其耐药性监测,用于指导临床医师合理使用抗菌药物,控制耐药菌株在医院中的流行。
OBJECTIVE To investigate the distribution and antibiotic resistance of Klebsiella pneumoniae in the First Affiliated Hospital of Guangxi Medical University from 2006 to 2015,so as to provide references for rational use of antibiotics in clinic.METHODS K.pneumoniaeisolated from the outpatients,emergency and inpatient departments of the hospital from 2006 to 2015 were retrospectively analyzed.The distribution and drug sensitivity of K.pneumoniae were analyzed.RESULTS A total of 7442 isolates of K.pneumoniae were collected in the First Affiliated Hospital of Guangxi Medical University from 2006 to 2015.Majority of 7442 isolates of K.pneumoniae were from inpatients（96.86% ）and sputum samples（52.14% ）.The resistance rate of K.pneumoniae showed an increasing trend in the ten years.The detection rate of ESBL-positive strains in K.pneumoniae was about 60% .The resistance rates of K.pneumoniaeto cefoperazone/sulbactam,ceftazidime and aztreonam increased from 2.20% ,20.10% and 17.30% to 27.40% ,41.60% amd 48.60% .The resistance rates of K.pneumoniaeisolated from ICU were the highest,followed by pediatrics,surgery and internal medicine.CONCLUSION The resistance rates of K.pneumoniaecollected from the First Affiliated Hospital of Guangxi Medical University are serious.The resistance rates of K.pneumoniae with different ages and different departments have big differences.Management of antimicrobial agents and surveillance of antimicrobial resistance are important for rational antimicrobial therapy and effective prevention and control of the spread of resistant K.pneumoniae strains.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第18期4089-4092,共4页
Chinese Journal of Nosocomiology
关键词
肺炎克雷伯菌
抗菌药物
耐药性
Klebsiella pneumoniae
Antimicrobial agent
Antimicrobial resistance
