【摘要】 目的　了解某院近 5年肺炎克雷伯菌的分布及耐药情况 ,指导临床合理选择抗菌药物。方法　回顾分析某院 1 999年 1月～ 2 0 0 3年 9月肺炎克雷伯菌的标本来源、分离率及耐药性变化。结果　肺炎克雷伯菌主要分离自重症监护病房送检标本 (35 .6 0 % ) ,5 0 %分离自痰标本 ;连续 5年对亚胺培南的敏感率最高 ,其次是阿米卡星、哌拉西林 /他唑巴坦 ;对氨苄西林 1 0 0 %耐药。产超广谱 β 内酰胺酶 (ESBLs)肺炎克雷伯菌的检出率由 1 999年的1 4 .2 8%上升至 2 0 0 3年的 4 6 .0 0 % ,其耐药率远远高于非产ESBLs菌株。结论　危重患者和免疫力低下的人群是肺炎克雷伯菌的易感人群。肺炎克雷伯菌的耐药率呈遂年增高趋势 ,其产ESBLs菌株检出率的增高应引起临床高度重视。更多还原

【Abstract】 Objective To investigate the distribution and antimicrobial resistance of Klebsiella pneumoniae in a hospital in recent five years, and provide reference for the rational use of antimicrobial agents in clinic. Methods The isolation rates and antimicrobial resistance of Klebsiella pneumoniae from different samples in a hospital between January 1999 and September 2003 were analyzed retrospectively. Results Infections caused by Klebsiella pneumoniae were frequently occurred in patients in intensive care units ( 35.60% ); and most strains ( 50.00% ) were isolated from sputum samples, imipenem was the most sensitive antimicrobial agents against Klebsiella pneumoniae infection, followed by amikacin and piperacillin/tazobactam, all strains of Klebsiella pneumoniae were resistant to ampicillin. The isolation rate of extended spectrum β lactamases (ESBLs) producing Klebsiella pneumoniae increased from 14.28% in 1999 to 46.00% in 2003, which was higher than that of non ESBLs producing Klebsiella pneumoniae. Conclusion Critical and immunocompromised patients are subject to infection caused by Klebsiella pneumoniae, antimicrobial resistant rates are increasing every year, the increased isolation of ESBLs producing Klebsiella pneumoniae in clinic should be paid attention.更多还原