新生儿病房肺炎克雷伯菌感染调查及耐药性分析

    Observation of Klebsiella pneumoniae infection in neonatal ward and analysis of the drug resistance

    • 摘要: 目的:调查新生儿病房肺炎克雷伯菌感染及耐药性,为指导临床合理使用抗菌药物提供依据。方法:对2008年6月至2010年6月新生儿病房分离出的肺炎克雷伯菌(ATBTM New生化分析鉴定仪)及其耐药性(K-B法测定)进行回顾性分析。结果:共检出肺炎克雷伯菌123株,其中痰和咽拭子标本检出76株,气管插管标本18株,血液标本15株,尿液9株,其他标本5株。肺炎克雷伯菌对头孢菌素类抗生素耐药率最高,对亚胺培南、含酶抑制剂头孢菌素敏感性最高。肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)检出率为60.9%。结论:新生儿病房肺炎克雷伯菌产ESBLs率较高,且对常用抗菌药物耐药严重,呈多药耐药,应引起临床的重视;亚胺培南、含酶抑制剂头孢菌素可作为新生儿克雷伯菌肺炎的首选药物。

       

      Abstract: Objective: To investigate Klebsiella pneumoniae infection in neonatal ward and its drug resistance so as to provide basis for rational use of antibiotics. Methods: Klebsiella pneumonia isolated by ATBTM New biochemical identification system in neonatal ward from Jun. 2008 to Jun. 2010 and the drug resistance (determined by K-B) were analyzed retrospectively. Results: A total of 123 strains of Klebsiella pneumoniae were isolated from the samples. Of them,76 were isolated from sputum and throat swab specimens,18 from tracheal intubations,15 from blood samples,9 from the urine and 5 from other specimens. Klebsiella pneumoniae was highly resistant to cephalosporin antibiotics and sensitive to imipenem and cephalosporins containing enzyme inhibitor. The rate of extendedspectrum β-lactamases (ESBLs) producing strains in Klebsiella pneumoniae was 60.9%. Conclusions: Klebsiella pneumoniae in neonatal ward produces high ESBLs, and is highly resistant to commonly used antimicrobial, presenting multidrug resistance, which should arouse the attention of the clinicians. Imipenem and cephalosporin containing inhibitors can be selected as the first choice for treatment of neonatal Klebsiella pneumoniae.

       

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