赵会玲

[摘要] 目的 通过分析2013～2014年肺炎克雷伯菌医院感染特点及耐药性，以期为临床用药提供指导。 方法 对2013～2014年我院临床分离出的518株肺炎克雷伯菌进行分析。采用K-B方法检测其对抗生素的耐药性，采用三维试验方法检测ESBLs及AmpC酶。 结果 肺炎克雷伯菌检出标本中痰的构成比最高。肺炎克雷伯菌临床分布分析结果显示，ICU的构成比最高，其次为烧伤科。药敏试验结果显示对哌拉西林的耐药率最高，其次为复方新诺明，对美洛培南没有耐药，对亚胺培南的耐药率也较低。共有167株检测出ESBLs，占32.2%，33株检测出AmpC酶，检出率6.4%。 结论 克雷伯杆菌是常见的医院感染病原菌，呼吸道感染比例较高，ICU科室感染率比例较高，对替卡西林、哌拉西林的耐药率最高，对美洛培南无耐药，ESBLs检出率较高，AmpC酶也有一定的检出率。

[关键词] 肺炎克雷伯菌；医院感染；耐药性；超广谱β-内酰胺酶

[中图分类号] R446.5 [文献标识码] B [文章编号] 1673-9701（2015）25-0099-03

Analysis of drug resistance and hospital infection of Klebsiella pneumoniae 2013-2014

ZHAO Huiling

Laboratory Department， Puyang People's Hospital in He'nan Province， Puyang 457000， China

[Abstract] Objective To provide guidance for clinical medicine by analyzing 2013-2014 Klebsiella pneumoniae hospital infection characteristics and drug resistance. Methods All 518 Klebsiella pneumoniae isolated in our hospital in 2013-2014 were analyzed. Drug resistance was detected with K-B test， and ESBLs and AmpC enzyme were detected with three-dimensional test. Results Klebsiella pneumoniae detected in sputum samples constituted the highest ratio. Klebsiella pneumoniae clinical distribution analysis showed that， ICU constituted the highest ratio， followed by the department of burn. Susceptibility test results showed that the rate of Klebsiella pneumoniae resistance to piperacillin was highest， followed by cotrimoxazole， no resistant to Meropenem， and resistance rate to imipenem was low. A total of 167 ESBLs was positive， accounting for 32.2%， and 33 AmpC enzyme was positive， accounting for 6.4%. Conclusion Klebsiella is common hospital infection pathogens， with higher respiratory tract infection ratio， higher infection ratio of ICU departments， and high resistance rates to ticarcillin， piperacillin， and no resistance to Meropenem. The detection rate of ESBLs is high， and AmpC enzyme also has some detection rate.

[Key words] Klebsiella pneumoniae； Hospital infection； Drug resistance； ESBLs

肺炎克雷伯菌存在于人体上呼吸道和肠道，当机体抵抗力降低时，便经呼吸道进入肺内而引起大叶或小叶融合性实变，以上叶较为多见。肺炎克雷伯菌是临床常见的医院感染病原菌，而因为抗生素在临床的广泛应用，其耐药性也越来越严重[1，2]。本研究通过对2013～2014年我院临床分离的518株肺炎克雷伯菌进行分析，分析其医院感染的特征以及耐药性情况，现报道如下。

1 资料与方法

1.1 一般资料

纳入研究的为2013～2014年在临床分离的518株肺炎克雷伯菌，分离标本包括创面分泌物、痰液等。均经ATB细菌鉴定仪鉴定。……