产β-ESBLs大肠艾希氏菌和肺炎克雷伯病原菌的耐药性分析

摘要

Objective:To analyze the drug resistance of β-ESBLs producing escherichia coli and klebsiella pneumonia pathogens,in order to provide important reference for the clinical rational use of antimicrobial agents. Method:6931 clinical specimens were collected in our hospital from January to December 2014.Drug sensitivity test was conducted by using K-B method and WHONET-5 system was used to analyze the distribution of drug resistant pathogens. Result:2724 positive samples were isolated from 6931 specimens.In the 2724 positive samples,309 escherichia coli strains and 147 strains of klebsiella pneumoniae were isolated.Among them β-ESBLs-producing escherichia coli bacteria had 234 strains,the isolation rate was 75.73%,β-ESBLs-producing klebsiella pneumoniae had 71 strains, the isolation rate was 48.30%.20 strains of the 234 β-ESBLs-producing escherichia coli were resistant to carbapenem antibiotics,accounting for 8.75%.10 strains of 71 β-ESBLs-producing positive klebsiella pneumoniae were resistant to carbapenem antibiotics,accounting for 14.08%.The drug resistant rates of the two pathogens to Imipenem,Meropenem, Piperacillin,Tazobactam,Cefoperazone and Sulbactam were lower.Conclusion:In our hospital,the separation rates ofβ-ESBLs-producing escherichia coli and klebsiella pathogenic were higher in 2014.They has high drug resistance rates and multiple drug resistance phenomeno.We must strengthen the monitoring of drug resistance of β-ESBLs-producing bacteria,provide the results of drug sensitivity test for clinical timely and accurately,promote the rational use of antimicrobial drugs,in order to prevent the outbreak or epidemic of β-ESBLs-producing bacteria in nosocomial.%目的:对产β-ESBLs大肠艾希氏菌和肺炎克雷伯病原菌的耐药性进行统计分析,为临床合理使用抗菌药物提供重要参考依据.方法:采集本院2014年1-12月6931份临床送检标本,对病原菌进行分离培养、鉴定.药敏试验采用K-B法,耐药性分析采用WHONET-5系统.结果:6931份标本中分离出阳性标本2724份.在2724份阳性标本中,分离出大肠埃希菌309株,肺炎克雷伯菌147株;其中产β-ESBLs阳性大肠艾希氏菌234株,分离率75.73%,产β-ESBLs阳性肺炎克雷伯菌71株,分离率48.30%.234株产β-ESBLs阳性大肠艾希氏菌中耐碳青霉烯类抗菌药物的大肠艾希氏菌有20株,占8.75%;71例产β-ESBLs阳性肺炎克雷伯菌中耐碳青霉烯类抗菌药物有10例,占14.08%.两种细菌对碳青霉烯类药物亚胺培南和美洛培南及酶抑制剂哌拉西林/他唑巴坦和头孢哌酮/舒巴坦的耐药率均较低.结论:2014年本院产β-ESBLs大肠艾希氏菌和肺炎克雷伯病原菌分离率较高,出现较高耐药率和多重耐药现象,必须加强对β-ESBLs细菌的耐药性监测,及时准确地为临床提供药敏试验结果,促使临床合理使用抗菌药物,预防产β-ESBLs细菌在院内暴发或流行.