Susceptibility of Klebsiella pneumoniae clinical strains isolated from 2010 to 2014 in Sir Run Run Shaw hospital of Hangzhou
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摘要: 目的 掌握近年来杭州邵逸夫医院临床分离的肺炎克雷伯菌的药敏情况,分析其对常用抗生素的耐药性变迁,为治疗及制定预防控制其感染的策略提供依据。 方法 采用梅里埃vitek2 compact全自动细菌鉴定药敏系统结合纸片扩散法进行抗菌药物的敏感试验,双纸片协同试验进行超广谱β-内酰胺酶(ESBLs)检测,对2010-2014年间杭州邵逸夫医院从临床分离的2 269株肺炎克雷伯菌的耐药性、ESBLs的分离率、产ESBLs与非产ESBLs菌的药敏结果差异等方面进行统计分析。 结果 肺炎克雷伯菌对β-内酰胺类的大多数药物耐药率呈逐年上升趋势;该菌对氨苄西林耐药率一直很高,对氨基糖苷类、喹诺酮类及复方新诺明等抗菌药物的耐药率5年来总体变化较小,对碳青霉烯类的耐药率上升明显,但后3年趋于稳定;同时几种β-内酰胺类抗菌药物与酶抑制剂合剂的耐药率增长明显。2010-2014年产ESBLs的肺炎克雷伯菌检出率较高,且产ESBLs菌株对大多数抗菌药物的耐药率显著高于非产ESBLs菌株(P<0.05)。 结论 肺炎克雷伯菌对常用抗菌药物的耐药性5年间呈普遍增长的趋势,产ESBLs菌株较非产ESBLs菌株其耐药性均有不同程度的增加。Abstract: Objective To investigate the resistance to antibiotics of Klebsiella pneumoniae among clinical isolates in recent years. Methods Vitek2 compact and K-B method were applied to analyze the drug susceptibility,the productive rate of ESBLs and the difference of drug sensitivity result between ESBLs negative and ESBLs positiveof the 2 296 strains of Klebsiella pneumoniae isolated from Sir Run Run Shaw hospital from 2010 to 2014.In the meantime thedouble-disk synergy test was used to confirm the ESBLs. Results The resistance rates of Klebsiella pneumoniae to most of the β-lactamases antibiotics rose year by year.The resistance rates toampicillin kept stable and high to 98% in the five years,but the one to Aminoglycosides,Quinolones and SMZ-TMP showed little changed during the five years.The resistance rate also had an upward trend to the carbapenems and comprised β-lactamases antibiotic.During the last five years,the positive rate of the ESBLs was high,and the resistance rate to most of the experimental antibiotics of ESBLs positive strains was obviously higher than that of thenegative one (P<0.05). Conclusion The resistance rate of the Klebsiella pneumoniae to most antibioticsincreases year by year during the past five years.The ESBLs positive strains have higher resistance rate as compared with ESBLs negative.We should choose the rational antibiotics according to the characteristic of the strain as well as the test report of the drug sensitivity.
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Key words:
- Klebsiella pneumoniae /
- Microbial susceptibility testing /
- ESBLs /
- Drug resistance rate
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