老年呼吸科患者感染产超广谱β-内酰胺酶肺炎克雷伯菌耐药分析

摘要

目的：了解老年呼吸科患者感染产超广谱β-内酰胺酶( ESBLs )肺炎克雷伯菌的分布及耐药性，为临床合理使用抗菌药物提供依据。方法采用法国生物梅里埃公司的VPI微生物自动鉴定系统，对我院2012年至2013年，老年呼吸科患者的各类临床标本进行细菌鉴定，药敏试验采用琼脂扩散法检测14种抗生素敏感性，并药敏结果进行分析。结果506株肺炎克雷伯菌标本分布以痰液为主，其中产ESBLs肺炎克雷伯菌258株，检出率为49．01%，检出506株肺炎克雷伯菌与其他细菌形成混合感染有164株(占32．14%)，铜绿假单胞菌合并肺炎克雷伯杆菌52例，占31．7%，产ESBLs 肺炎克雷伯菌耐药率明显高于非产ESBLs 肺炎克雷伯菌。结论老年呼吸科患者产ESBLs肺炎克雷伯菌对临床常用抗菌药物的耐药率较高，所以监测产ESBLs 的发生率及其耐药趋势能够预防和控制耐药菌的产生和传播。%Objective To understand the drug resistance of extended spectrum B-lactamases producing Klebsiella pneumonia in in elderly patients in the department of respiration in order to provide the basis for rational use of antimicrobial agents. Methods The clinical samples were collected from elderly patients in the Department of Respiration from 2012 to 2013. Isolated bacterial were identified and analyzed by VPI system. Drug sensitivity to 14 kinds of antibiotics were tested by disk diffusion and the results were analyzed. Results A total of 506 Klebsiella pneumoniae mainly came from sputum specimens of which 248 strains produced ESBLs. The infection of 506 strains of Klebsiella pneumoniae and other bacteria was 164 (32. 14%), P. aeruginosa and K. Pneumoniae (52/164, 31. 7%) . The drug resistance of Klebsiella pneumonia producing ESBLs was higher than that of non-producing ES-BLs. Conclusion The isolates of ESBLs-producing Klebsiella pneumonia in elderly patients in the Department of Respiration are highly resistant to the commonly used antibiotics. Therefore, the monitoring of the incidence o f ES-BLs producing strains should be strengthened to prevent and control the production and spread of multi-drug resist-ance.