摘要
目的探讨肺炎克雷伯菌(KPN)的临床分布特点及其耐药性变化。方法对2014-2018年临床分离的2169株KPN的临床分布及药物敏感性进行分析,细菌的鉴定和药敏试验使用VITEK-2 Compact细菌鉴定、药敏分析系统及纸片扩散法。结果KPN分离自痰液标本的占26.6%;来自ICU、颅脑外科、泌尿外科的菌株分别占11.0%、7.3%、6.5%。2014-2018年,各年份间产超广谱β-内酰胺酶(ESBLs)KPN的检出率差异无统计学意义(P>0.05),但耐碳青霉烯类抗菌药物肺炎克雷伯菌(CRKP)在2018年明显增高(P<0.05)。KPN对厄他培南和亚胺培南的耐药率均在2018年达到最高,分别为10.7%和11.1%。KPN中产ESBLs KPN的总检出率为39.3%,除哌拉西林/他唑巴坦、头孢替坦、厄他培南、亚胺培南和阿米卡星外,产ESBLs KPN对常用抗菌药物的耐药率明显高于不产ESBLs KPN(P<0.05)。结论KPN是呼吸道和泌尿道感染的常见病原菌,临床应加强抗菌药物的合理应用,减缓耐药菌株的出现。
Objective To investigate the clinical distribution and drug resistance of Klebsiella pneumoniae(KPN).Methods The clinical distribution and drug sensitivity of 2169 clinical isolates of KPN from 2014 to 2018 were analyzed.Vitek-2 Compact bacterial identification,drug sensitivity analysis system and disk diffusion method were used for bacterial identification and drug sensitivity test.Results 26.6%of KPN strains were isolated from sputum,11.0%,7.3%and 6.5%from ICU,craniocerebral surgery and urology department,respectively.There was no significant difference in the detection rate of extended spectrumβ-lactamases(ESBLs)producing KPN among the years from 2014 to 2018(P>0.05),but the carbapenem resistant Klebsiella pneumoniae(CRKP)increased significantly in 2018(P<0.05).The total detection rate of ESBLs producing KPN was 39.3%.Except piperacillin/tazobactam,cefotetan,ertapenem,imipenem and amikacin,the resistance rate of ESBLs producing KPN to commonly used antibiotics was significantly higher than that of ESBLs negative KPN(P<0.05).Conclusion KPN is a common pathogen of respiratory tract and urinary tract infection.The rational use of antibiotics should be strengthened to slow down the emergence of drug-resistant strains.
作者
符小芳
蔡木发
王柔升
FU Xiaofang;CAI Mufa;WANG Rousheng(Department of Clinical Laboratory,Affiliated Hospital of Guangdong Medical University,Zhanjiang,Guangdong 524001,China)
出处
《检验医学与临床》
CAS
2020年第14期2020-2022,2026,共4页
Laboratory Medicine and Clinic
