王　蓓，　艾芙琪，　邹　雪，　蒋晓飞

(复旦大学附属华山医院检验科，上海 200040)

脑外科监护病房肺炎克雷伯菌的耐药情况分析

王蓓，艾芙琪，邹雪，蒋晓飞

(复旦大学附属华山医院检验科，上海 200040)

摘要：目的了解华山医院脑外科监护病房肺炎克雷伯菌的耐药情况及其特点。方法收集脑外科监护病房送检标本分离出的肺炎克雷伯菌233株进行药物敏感性试验。结果233株肺炎克雷伯菌中77.3%来源于呼吸道标本，总体耐药率逐年提升。呼吸道标本分离出的肺炎克雷伯菌对哌拉西林-他唑巴坦、头孢哌酮-舒巴坦、亚胺培南、美罗培南以及厄他培南耐药率明显低于非呼吸道标本(P<0.05)。结论呼吸道标本分离出的肺炎克雷伯菌和非呼吸道标本分离出的肺炎克雷伯菌对药物敏感性存在差异，必须继续加强医院感染监控，避免滥用抗菌药物。

关键词：肺炎克雷伯菌；呼吸道标本；定植菌；医院感染

中图分类号：

文章编号：1673-8640(2015)01-0010-03R446.5

文献标志码：码：A

DOI：10.3969/j.issn.1673-8640.2015.01.003

Abstract:ObjectiveTo analyze the antibiotic resistance and characteristic of Klebsiella pneumoniae isolated from neurosurgical intensive care unit in Huashan Hospital. MethodsA total of 233 Klebsiella pneumoniae isolates were collected from neurosurgical intensive care unit. Antibiotic susceptibility of the isolates was determined. ResultsA total of 77.3% of 233 isolates of Klebsiella pneumoniae were collected from respiratory tract samples. The total resistance rates to antibiotics increased year after year. The resistance rates to piperacillin-tazobactam, cefoperazone-sulbactam, imipenem, meropenem and ertapenem for respiratory tract samples were obviously lower than those for non-respiratory tract samples (P<0.05). Conclusions There is a contrast between the antibiotic susceptibility of the respitatory specimens and the non respiratory specimens. The monitoring of nosocomial infection should be strengthened to avoid misusing antibiotics.

作者简介：王蓓，男，1984年生，学士，技师，主要从事微生物学检验工作。

通讯作者：蒋晓飞，联系电话：021-52888316。

收稿日期：(2013-12-17)

Analysis on the antibiotic resistance ofKlebsiellapneumoniaeisolated from neurosurgical intensive care unitWANGBei,AIFuqi,ZOUXue,JIANGXiaofei.(DepartmentofClinicalLaboratory,HuashanHospital,FudanUniversity,Shanghai200040,China)

Key words:Klebsiellapneumoniae; Respiratory tract sample; Colonization bacterium; Nosocomial infection

肺炎克雷伯菌作为条件致病菌存在于人体上呼吸道和肠道。当机体抵抗力降低时，特别是病情危重时，可引起各类感染甚至血流感染，是临床分离及医院感染的重要病原菌之一。近年来其耐药性变化以及多重耐药菌株的增加，更加引起临床医生以及医院感染控制人员的重视。作为华山医院重点科室，脑外科监护病房长期收治脑外科手术后或脑部严重损伤的重症患者。我们对2009至2012年华山医院脑外科监护病房的肺炎克雷伯菌耐药性变迁情况进行分析，旨在引起临床科室对肺炎克雷伯耐药性的重视，降低医院感染率，提高医院感染预防控制措施和治疗水平。……