[关键词]
[摘要]
目的 了解天津中医药大学第二附属医院肺炎克雷伯菌的分布及耐药性,为临床合理用药提供依据。方法 对2011年1月—2014年12月天津中医药大学第二附属医院肺炎克雷伯菌的分布及耐药情况进行回顾性统计分析。结果 共分离出1 245株肺炎克雷伯菌,科室分布主要为肺病科,占65.14%,标本主要来源于痰液及咽拭子。肺炎克雷伯菌对氨苄西林的耐药率高达98.96%,耐药率较高的是哌拉西林、头孢唑啉和头孢曲松,耐药率较低的是亚胺培南、美罗培南、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦。除亚胺培南、美罗培南、头孢吡肟和氨苄西林外,ESBLs阳性肺炎克雷伯菌对其他抗菌药物的耐药率均明显高于ESBLs阴性菌株。结论 肺炎克雷伯菌的多重耐药现象严重,对常用抗菌药物耐药率呈上升趋势,建议临床根据药敏结果合理使用抗菌药物。
[Key word]
[Abstract]
Objective To study the distribution and drug resistance of Klebsiella pneumoniae in Second Affiliated Hospital of Tianjin University of TCM, and to provide reference for rational drug use. Methods The distributions and drug resistances of K. pneumoniae in Second Affiliated Hospital of Tianjin University of TCM from January 2012 to December 2014 were reviewed, retrospectively. Results Totally 1 245 strains of bacteria were isolated. The department distributed widely in department of pulmonary disease, which accounted for 65.14%. The specimens were mainly obtained from the sputum and throat swab. The drug resistance rate of K. pneumoniae against ampicillin was up to 98.96%, followed by piperacillin, cefazolin/ceftriaxone. The drug resistance rates of K. pneumoniae against imipenem, meropenem, and piperacillin-tazobactam/cefoperazone-sulbactam were low. The drug resistance rate of ESBLs positive K. pneumoniae to antibacterial drugs was significantly higher than that of the ESBLs negative strains except for imipenem, meropenem, cefepime, and ampicillin. Conclusion Multiple drug resistance of K. pneumoniae is serious, and there is an upward trend in resistance to common antibacterial drugs. Therefore clinic should reasonably use antibacterial drugs based on the results of drug susceptibility test.
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[基金项目]
国家自然科学基金资助项目(81373849)