【摘要】 目的　分析比较天津市临床分析的大肠埃希菌、肺炎克雷伯菌对常用抗生素的耐药情况。方法　搜集天津市 8所大型综合医院 2 0 0 1年 8月～ 2 0 0 2年 3月临床分析的 4 2 1株大肠埃希菌和 4 18株肺炎克雷伯菌 ,进行药物敏感性测定 ,同时判断菌株来源是否为医院感染的患者。结果　医院感染株对绝大部分抗生素的耐药率都高于社区感染的菌株 ,其结果有统计学意义 ,医院感染株 ESBL s产生比例也高于社区感染株 ,其结果存在统计学差异 ,亚胺培南、阿米卡星、头孢他啶对上述两菌仍有良好的抗菌活性 ;对喹诺酮类、环丙沙星耐药率 ,大肠埃希菌医院内、外分别为 71.9%和 6 1.1% ,对肺炎克雷伯分别为 32 .2 %和 2 1.8% ,两者之间无统计学意义 ;大肠埃希菌对庆大霉素耐药率医院内、外分别为 6 0 .3%和 4 8.1% ,两者之间无统计学意义。结论　医院感染分离株耐药率高于医院外分离株 ,应引起经验性使用抗生素的注意 ,对环丙沙星和庆大霉素的耐药可能与环境因素相关。更多还原

【Abstract】 OBJECTIVE To compare and analyze clinical isolates of Klebsiella pneumoniae and Escherichia coli. METHODS There were 421 isolates of K. pneumoniae and 418 isolates of E. coli collected from eight Tianjin general hospitals from Mar 2001 to Mar 2002. All the isolates were measured by antimicrobial susceptibility testing and meanwhile judged whether the strains were isolated from the nosocomial infection patients. RESULTS The resistant rate to most antibiotics of isolates from nosocomial infection was higher than that from community one, including ESBLs producing strains of isolates. There was statistically significant difference between them. Imipenem, amikacin and ceftazidime shown higher antimicrobial activity to most of isolates. But fluoroquinolones and ciprofloxacin, formerly had very good activity to E. coli and K. pneumoniae, now shown higher resistant rates. There was no statistically significant difference between nosocomial infection and community one. CONCLUSIONS The resistant rate of isolates from nosocomial infection was higher than that of isolates from community one. It is needed to be of great concern about empiric antibiotic therapy.更多还原