【摘要】 目的掌握桂西山区医院肺炎克雷伯菌(KPN)引起医院感染的临床分布及耐药特征,为临床医师合理用药提供依据。方法 487株KPN培养和鉴定严格按照《全国临床检验操作规程》进行,采用VITEK-32全自动细菌鉴定系统进行菌株鉴定和药物敏感性试验,统计分析了医院感染和非医院感染KPN的耐药性。结果医院感染KPN分离率较高的临床科室是ICU占30.33%、呼吸内科占22.00%和新生儿科占14.67%;临床标本以呼吸道标本占37.67%和尿液标本占24.33%为主;除头孢西丁、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南、美罗培南和氨苄西林外,医院感染KPN的耐药率均显著高于非医院感染差异有统计学意义(P<0.01);医院感染KPN产ESBLs阳性率为31.67%,对11种抗菌药物的耐药率为22.33%～98.00%。结论桂西山区的KPN已经成为医院感染的主要病原菌之一,耐药性日趋严重,医院应采取有效措施,预防和控制耐药菌株引起的医院感染。更多还原

【Abstract】 OBJECTIVE To investigate the distribution and the antimicrobial of Klebsiella pneumoniae(KPN) isolated from clinic in Guangxi mountain west conference hospital to help doctors to use antibiotic reasonably. METHODS Referring to the National Guide to clinical laboratory procedure,487 KPN strains were isolated and identified.The strains and drug sensitivity were VITEK 32 system,and the drug resistance was analyzed the drug resistance in hospital infection and the drug resistance in not hospital infection. RESULTS ICU(30.33%),Respiratory Physicians(22.00%),Division of Neonatology(14.67%) were found to have higher isolation rate among the hospital-acquired infections caused by KPN,The respiratory tract infections(37.67%) and urine(24.33%) that had the highest detection rate.Except for cefoxitin,cefoperazone/sulbactam,piperacillin/tazobactam,ampicillin and meropenem,the resistant rate to other antimicrobial agents was significantly higher in hospital infection than not hospital infection(P<0.01).The detection rate of the extended spectrum β-lactamases(ESBLs)-producing KPN in hospital infection was 31.67%;That the resistant rate of KPN was high(22.33%-98.00%) to eleven other antibiotics. CONCLUSION KPN has become one of the main pathogens of hospital-acquired infection to Guangxi mountain west conference hospital,and its resistance is serious.Hospital should take effective measurement to prevent and control nosocomial infections with drug resistant strains.更多还原