新生儿肺炎克雷伯菌肺炎药敏分析

摘要

目的 了解新生儿肺炎克雷伯菌肺炎的药敏情况,及产超广谱β-内酰胺酶(ESBLs)的发生率,为合理使用抗生素治疗提供依据.方法 收集本院2008年8月-2009年5月新生儿肺炎克雷伯菌肺炎71例痰液标本,采用法国BioMerieux VITEK2 Compact全自动细菌鉴定仪对临床分离菌株进行鉴定及药敏检测,以及超广谱-β内酰胺酶(ESBLs)的检测,对其临床资料进行回顾性分析.结果 肺炎克雷伯菌ESBLs发生率为71.8%肺炎克雷伯菌对亚胺培南、头孢替坦敏感率达100%,对近几年在新生儿较少用的阿米卡星、环丙沙星的敏感率为80%～90%,而对常用氨苄西林不敏感,对头孢菌素敏感率低.产ESBLs菌株耐药性比非产ESBLs菌株强.结论 新生儿肺炎克雷伯菌中为产ESBLs菌株比例较高.耐药性强.应根据药敏试验结果选择敏感抗生素,及时控制疾病的发展,降低病死率.%Objective To probe into the drug sensitivity about newborn pneumonia of Klebsiella pneumoniae(Kp) and investigate the positive rate of extended-spectrum β-lactamases(ESBLs) in klebsiella pneumoniae.and provide the evidence of reasonable treatment. Method 71 cases of sputum samples new-born pneumonia ofklebsiella pneumoniae from july2008 to may2009 were collected use BioMerieux VITEK2 Compact to Bacteria identification and drug sensitivity testwere per-formed. At the same time, ESBLs were detected. Results the positive rate of ESBLs in klebsiella pneumoniae was 71.8 %, Kp was 100% sensitive to carbopenems, e.g lmipenen, Meropenen, and 80%～90% to Amikacin and Ciprofloxacin,which were hardly used in newborn recent years. While it was resistant to commonly used Penicillin and Cephalosporin.. ESBLs negative strains had higher drug sensitivity than ESBLs strain.Conclusions Partial klebsiella pneumoniae are ESBLs strains and insensitive to commonly used antibiotics. In order to decrease ESBLs strains, the antibiotics treatment shall be used appropriately and the selection of antibiotics shallbe guided by the results ofdrug sensitivity tests.