摘要
目的了解非痰标本肺炎克雷伯菌的分布特点及耐药性变迁,为临床合理选用抗菌药物提供参考。方法收集2011-2015年非痰标本分离肺炎克雷伯菌468株,采用Phoenix-100全自动细菌鉴定药敏系统进行鉴定并测定MIC,双纸片协同扩散法检测ESBLs,参照美国临床和实验室标准化协会(CLSI)标准,三维试验法检测AmpC,并对结果进行统计分析。结果非痰标本肺炎克雷伯菌占6.17%,占肠杆菌科15.15%;对头孢噻肟、阿莫西林/克拉维酸、氨苄青霉素、氨曲南、哌拉西林、哌拉西林/他唑巴坦、头孢西丁、头孢哌酮、头孢他啶、头孢吡肟、美罗培南、氨苄西林/舒巴坦等12种抗菌药物的耐药率上升趋势明显(P<0.05);ESBLs与AmpC酶检出率逐年上升(P<0.05)。结论非痰标本分离肺炎克雷伯菌的ESBLs与AmpC酶检出率与耐药性逐年上升,临床应合理选用抗菌药物,减少耐药性的发生。
OBJECTIVE To understand the distribution characteristics and drug resistance of Klebsiella pneumoniae in non sputum specimens, so as to provide references for rational use of antibiotics in clinic. METHODS A total of 468 strains of non sputum isolates of Klebsiella pneumoniae were collected from Jan. 2011 to Dec. 2015. The strains were identified and determined by MIC Phoenix-100 automatic bacterial identification and susceptibility sys- tem, double disk diffusion method was used for detection of ESBLs, and 3D test method was used for detection of AmpC according to the Clinical and Laboratory Standards Institute （CLSI） standard. The results were statistically analyzed. RESULTS The non sputum specimens of Klebsiella pneumoniae accounted for 6.17% of the total num- ber of pathogenic bacteria, and Enterobacteriaceae accounted for 15.15%. The drug resistant rates to 12 kind of antibiotics of cefotaxime, amoxicillin/clavulanic acid, ampicillin, aztreonam, piperacillin, piperacillin/tazobactam, cefoxitin, cefoperazone, ceftazidime, cefepime, imipenem, and ampicillin/sulbactam were increased significantly （P〈0.05）. ESBLs and AmpC enzyme detection rates were increased year by year （P〈0. 05）. CONCLUSION The detection rate and drug resistance of ESBLs and AmpC enzyme isolated from non sputum specimens of Kleb- siella pneumoniae are increased year by year. The rational use of antibiotics should be selected reasonably to re- duce the occurrence of drug resistance.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第8期1689-1692,共4页
Chinese Journal of Nosocomiology
基金
贵州省科技厅联合项目(黔科合LH字2014-7162)
贵州省黔南州社会发展科技基金资助项目(黔南科合社字2013-20)
关键词
非痰标本
肺炎克雷伯菌
耐药性
Non sputum specimen
Klebsiella pneumoniae
Drug resistance
