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目的深入了解医院肺炎克雷伯菌感染分布情况和耐药性,研究生物膜阳性肺炎克雷伯菌的基因型,为临床医师合理选择抗菌药物提供科学依据。方法收集2014年1月至2014年12月临床送检的各类感染性标本进行培养分离,检出545株肺炎克雷伯菌,采用VITEK-2Compact型全自动细菌分析鉴定系统,用GN卡对其进行鉴定,药敏采用AST-GN药敏卡进行药敏分析,PCR对形成生物膜肺炎克雷伯菌进行基因型检测。结果545株肺炎克雷伯菌中痰液、尿液、血液标本分别占59.45%、21.11%和12.29%;感染菌株主要分布于ICU、肿瘤一区、肿瘤二区、血液科,分别占40.55%、15.96%、14.50%和11.93%。对主要抗菌药物耐药率:氨苄西林为79.50%,厄他培南、亚胺培南分别为0.00%和0.30%,头孢替坦为1.10%。形成生物膜肺炎克雷伯菌主要基因型为TEM(41.60%)和SHV(29.16%)。结论我院肺炎克雷伯菌分离株耐药率相对较低,应该与我院中药使用有关,形成生物膜肺炎克雷伯菌以TEM和SHV为主。
Objective To understand the distribution and drug resistance of Klebsiella pneumoniae in hospital and to study the genotypes of Klebsiella pneumoniae with biofilm-positive in order to provide a scientific basis for clinicians to choose antibacterial drugs reasonably. Methods A total of 545 strains of Klebsiella pneumoniae were collected from various clinical samples collected from January 2014 to December 2014. VITEK-2 Compact automatic bacterial analysis and identification system was used. Its identification, drug susceptibility using AST-GN susceptibility card susceptibility analysis, PCR to form biofilm Klebsiella pneumoniae genotype detection. Results The sputum, urine and blood samples of 545 strains of Klebsiella pneumoniae accounted for 59.45%, 21.11% and 12.29% respectively. The infected strains mainly distributed in the ICU, tumor one, tumor two, hematology, accounting for 40.55% , 15.96%, 14.50% and 11.93% respectively. The rates of resistance to the major antimicrobial agents were ampicillin 79.50%, ertapenem and imipenem 0.00% and 0.30% respectively, and cefotetan 1.10%. The main genotypes of Klebsiella pneumoniae formed by biofilm were TEM (41.60%) and SHV (29.16%). Conclusions The Klebsiella pneumoniae isolates in our hospital have a relatively low resistance rate and should be related to the use of traditional Chinese medicine in our hospital. The biofilm-producing Klebsiella pneumoniae mainly consists of TEM and SHV.