| | | 肺炎克雷伯菌对抗生素的耐药性研究
| | 论文下载［摘要］ 目的论文下载 研究肺炎克雷伯菌对抗生素的论文下载耐药性及产ESBLs细菌感染的危险因素，指导临床合理用药。方法 应用WHONET 5分析我院２００6年1～12月临床分离的281株肺炎克雷伯菌的药敏结果。结果 肺炎克雷伯菌对头孢类抗生素如头孢他啶、头孢曲松、头孢吡肟、头孢呋辛钠、头孢呋辛酯、头孢唑啉、头孢替坦的耐药率分别为49.8%、49.8%、49.8%、61.0%、61.0%、53.1%和23.3%，亚胺培南和美洛培南未发生耐药；血、痰、尿三类标本间耐药率无明显差异。检出产ESBLs细菌97株，检出率34.5%。结论 肺炎克雷伯菌除对亚胺培南和美洛培南未发生耐药外，对其他抗生素均已高度耐药；产ESBLs的肺炎克雷伯菌对多种抗生素耐药率明显高于非产ESBLs株。
［关键词］ 肺炎克雷伯菌；耐药性；抗生素
Study on antibiotics resistance of Klebsiella pneumoniae
［Abstract］ Objective To investigate the antimicrobial resistance of clinical isolates of Klebsiella pneumoniae and the infective risk factor of ESBLs producing to rationalize clinical medication.Methods Antimicrobial susceptibility testing was done on 281 strains of Klebsiella pneumoniae isolated in our hospital from January 2006 to December 2006 and analyzed by software WHONET 5.Results The resistance rates of Klebsiella pneumonia to ceftazidine、ceftriaxone、cefepime、cefuroxime-sodium、cefuroxime-Aaxeril、cefotetan were 49.8%，49.8%，49.8%，61.0%，61.0%，53.1%，23.3% respectively.Ninety-seven strains of ESBLs-producing（34.5%） were obtained from Klebsiella pneumoniae.No strain resistant to imipenem and meropenem was found.Conclusion The resistance rate of Klebsiella pneumonia to antimicrobial is increasing markedly.Imipenem and meropenem still has the highest activity.The resistance rate of ESBLs has better activity than no-ESBLs to antimicrobial.
［Key words］ bacterial resistance;Klebsiella pneumonia;antimicrobial agents
肺炎克雷伯菌属革兰阴性杆菌，常寄殖于呼吸道和肠道，是下呼吸道感染的重要病原菌。近年来，由于第三代头孢菌素、β-内酰胺类及广谱抗生素的广泛使用，肺炎克雷伯菌已成为产超广谱β-内酰胺酶（ESBLs）的代表菌种，产生的选择性压力和耐药性日益突出［1］。为了解产ESBLs细菌感染的危险因素、临床流行状况及产酶株的耐药情况，防止细菌耐药性的发生和发展，更好地指导临床合理用药，笔者研究分析了我院２００6年1～12月临床分离的281株肺炎克雷伯菌的药敏结果，现将结果报告如下。
1 材料与方法
1.1 菌株来源 281株肺炎克雷伯菌均为我院临床标本中分离并按全国统一操作规程。标本主要包括血液、尿液、痰。
1.2 仪器试剂 VITEK-2型全自动微生物分析仪、ID-GN鉴定卡、AST-GN 09药敏卡由法国Bio-Merieux公司生产;VITEK比浊计（V 1210）由日本生产。
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