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目的:回顾性分析呼吸道肺炎克雷伯菌感染的耐药特点,为抗生素的合理使用提供参考。方法:我院儿科病房呼吸道感染住院患儿68例,经咽拭子、血液、尿液、气管插管末端样本分离肺炎克雷伯菌88株,采用纸片琼脂扩散法(K-B法)分析肺炎克雷伯菌耐药性和敏感性,参照NCCLS标准筛选产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌。结果:分离的88株肺炎克雷伯菌中产ESBLs肺炎克雷伯菌76株,产ESBLs肺炎克雷伯菌对头孢噻肟的耐药率最高,达88.6%,其次是头孢呋辛钠、头孢他啶、头孢曲松和氨苄西林/舒巴坦。对美罗培南、亚胺培南、环丙沙星、头孢哌酮/舒巴坦、头孢他啶/克拉维酸、头孢噻肟/克拉维酸的敏感率为100%。结论:浙江绍兴地区小儿呼吸道感染致病菌肺炎克雷伯菌对头孢菌素类抗生素耐药率较高,主要与产ESBLs菌种形成有关,而对美罗培南、亚胺培南、环丙沙星等的敏感性较高,临床应合理用药,预防产ESBLs革兰阴性菌的流行。
Objective: To retrospectively analyze the drug resistance characteristics of respiratory Klebsiella pneumoniae infection and provide a reference for the rational use of antibiotics. Methods: A total of 68 hospitalized children with respiratory tract infection in pediatric ward of our hospital were enrolled. Thirty-eight Klebsiella pneumoniae were isolated from throat swabs, blood, urine and endotracheal intubation samples. Pulmonary agar diffusion assay (KB method) Klebsiella pneumoniae drug resistance and sensitivity, with reference NCCLS standard screening of extended-spectrum β-lactamase (ESBLs) Klebsiella pneumoniae. Results: Among the 88 isolates of Klebsiella pneumoniae, 76 ESBLs - producing Klebsiella pneumoniae isolates were ESBLs - producing Klebsiella pneumoniae with the highest resistance rate of 88.6% to cefotaxime, followed by cefuroxime sodium, ceftazidime , Ceftriaxone and ampicillin / sulbactam. The sensitivity rate to meropenem, imipenem, ciprofloxacin, cefoperazone / sulbactam, ceftazidime / clavulanic acid, cefotaxime / clavulanic acid was 100%. Conclusion: Klebsiella pneumoniae, a pathogen of respiratory tract infection in children with respiratory tract infection in Shaoxing, Zhejiang Province, has a higher resistance rate to cephalosporins and is mainly related to the formation of ESBLs producing strains. However, meropenem, imipenem, The higher the sensitivity of the stars, the clinical should be rational use of drugs to prevent the prevalence of ESBLs Gram-negative bacteria.