摘要
目的:对黑龙江省东部地区某医院耐碳青霉烯类肺炎克雷伯菌(CRKP)做统计学分析,了解CRKP的临床分布及耐药特点,指导临床更好的用药。方法:收集2015～2017三年间黑龙江省某医院住院患者和门诊患者的标本对CRKP进行分离培养,用仪器VITEK 2和Walk Away 40 plus进行细菌鉴定和药敏试验,K-B法进行药敏试验复核。结果:筛选出77株CRKP,CRKP主要科室来源于ICU(30株,38. 96%)、神经科(23株,29. 87%)、急诊(7株,9. 09%);主要标本来源于痰液(60株,77. 92%)、血液(10株,12. 99%)。结论:CRKP对环丙沙星、氨曲南、氨苄西林、第二三代头孢的耐药率均较高(> 70%),对阿米卡星、头孢西丁、阿莫西林/克拉维酸的耐药率较低(<10%)。患者的痰液标本为筛选CRKP的主要来源,且多种药物对CRKP临床治疗效果不明显,医院应加强对抗生素的合理使用,加强对CRKP耐药性的监测,以药敏结果来指导临床用药,能有效避免耐药菌株的出现,减少临床医生用药的困难。
Objective： To analyze the clinical distribution and drug resistance of Klebsiella pneumoniae （CRKP）, and to provide effective data for clinical treatment of Klebsiella pneumoniae （Klebsiella pneumoniae） in a hospital in the eastern part of Heilongjiang province. Methods： The specimens of Klebsiella pneumoniae in the hospital during 2015-2017 years were collected and cultured. The bacterial identification and drug sensitivity test were carried out with the instrument VITEK 2 and Walk Away 40 plus, and the K-B method was used to recheck the drug sensitivity test. Results： 71 strains of CRKP were screened from 1224 strains of Klebsiella pneumoniae. The main sections of CRKP were derived from ICU （29, 40.85%）, Neurology （21,29.58%）, and emergency （7, 9.86%）. The main specimens were from sputum （58,81.69%）, and blood （9,12.68%）. Conclusion： The resistance rate of CRKP to ciprofloxacin, amamicillin, ampicillin and two or three generation cephalosporin was higher （〉70%）, and the resistance rate to Amikacin, cefoxitin and amoxicillin / clavulanic acid was lower （〈10%）. CRKP is the most widely distributed in the sputum of the infected patients, and it is highly resistant to commonly used antibiotics. The hospital should strengthen the rational use of antibiotics, strengthen the monitoring of drug resistance, guide the clinical use of drug sensitivity, and help reduce the emergence of drug-resistant.
作者
李慧玲
苏晓曼
张义
LI Hui ling;SU Xiao man;ZHANG Yi(Laboratory of the First Affiliated Hospital of Jiamusi University,Jiamusi 154003,China)
出处
《黑龙江医药科学》
2018年第5期34-35,共2页
Heilongjiang Medicine and Pharmacy
基金
佳木斯大学校级课题
编号:S2014-0017
