【摘要】 目的:了解我院肺炎克雷伯菌的临床分布及耐药性变迁。方法:对我院2005-2011年临床分离肺炎克雷伯菌的分布特点及耐药性进行回顾性分析。结果:2776株肺炎克雷伯菌主要来源于痰(占83.9%);科室分布以脑科分院ICU为主(占28.7%),其次为呼吸内科(占12.4%)。菌株对常用抗菌药物均有不同程度耐药,对头孢唑林的耐药率较高,均大于75%;对头孢他啶、头孢曲松、头孢吡肟、氨曲南、庆大霉素和复方磺胺甲唑的耐药率波动在55.2%～84.2%之间;对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、阿米卡星、妥布霉素和左氧氟沙星的耐药率相对较低,波动在10.6%～41.3%之间。2005-2011年产ESBLs株数占年度总株数的比例分别为76.6%、88.8%、93.1%、87.2%、72.5%、69.3%、68.8%;2009-2011年出现了对碳青霉烯类抗菌药物耐药的菌株,且有逐年上升趋势,由2009年的0.2%上升到2011年的4.0%。结论:肺炎克雷伯菌耐药情况日趋严重,耐碳青霉烯类菌株的产生及播散对临床预防和治疗造成极大困难,必须引起临床高度重视。更多还原

【Abstract】 OBJECTIVE:To study the clinical distribution and the drug resistance of Klebsiella pneumoniae in our hospital.METHODS:The distribution characteristics and resistance of K.pneumoniae isolated in our hospital from 2005 to 2011 were analyzed retrospectively.RESULTS:Most of 2 776 strains of K.pneumoniae were isolated from sputum specimens(accounted for 83.9%);and mainly collected from ICU in cerebral branch of the hospital(accounted for 28.7%),the next were from department of respiratory(accounted for 12.4%).All strains were resistant to commonly used antibacterials more or less.From 2005 to 2011,the resistance rates to cefazolin were greater than 75%,and the resistance rate fluctuated between 55.2% to 84.2% to ceftazidime,ceftriaxone,cefepime,aztreonam,gentamicin and compound sulfamethoxazole;the resistance rate was relatively low which fluctuated between 10.6% to 41.3% to piperacillin/tazobactam,cefoperazone/sulbactam,amikacin,tobramycin and levofloxacin.And the proportion of strains producing ESBLs accounted for 76.6%,88.8%,93.1%,87.2%,72.5%,69.3% and 68.8% of total number of strain,respectively.The carbapenem-resistant strains had emerged and showed an increasing trend from 2009 to 2011,rising from 0.2% in 2009 to 4.0% in 2011.CONCLUSIONS:The drug resistance of K.pneumoniae is increasingly severe.The occurrence and spread of carbapenem-resistant K.pneumoniae make great trouble for clinical prevention and treatment,on which should be focused in the clinic.更多还原