目的 了解天津中醫(yī)藥大學(xué)第二附屬醫(yī)院肺炎克雷伯菌的分布及耐藥性,為臨床合理用藥提供依據(jù)。方法 對(duì)2011年1月—2014年12月天津中醫(yī)藥大學(xué)第二附屬醫(yī)院肺炎克雷伯菌的分布及耐藥情況進(jìn)行回顧性統(tǒng)計(jì)分析。結(jié)果 共分離出1 245株肺炎克雷伯菌,科室分布主要為肺病科,占65.14%,標(biāo)本主要來(lái)源于痰液及咽拭子。肺炎克雷伯菌對(duì)氨芐西林的耐藥率高達(dá)98.96%,耐藥率較高的是哌拉西林、頭孢唑啉和頭孢曲松,耐藥率較低的是亞胺培南、美羅培南、哌拉西林/他唑巴坦和頭孢哌酮/舒巴坦。除亞胺培南、美羅培南、頭孢吡肟和氨芐西林外,ESBLs陽(yáng)性肺炎克雷伯菌對(duì)其他抗菌藥物的耐藥率均明顯高于ESBLs陰性菌株。結(jié)論 肺炎克雷伯菌的多重耐藥現(xiàn)象嚴(yán)重,對(duì)常用抗菌藥物耐藥率呈上升趨勢(shì),建議臨床根據(jù)藥敏結(jié)果合理使用抗菌藥物。

Objective To study the distribution and drug resistance of Klebsiella pneumoniae in Second Affiliated Hospital of Tianjin University of TCM, and to provide reference for rational drug use. Methods The distributions and drug resistances of K. pneumoniae in Second Affiliated Hospital of Tianjin University of TCM from January 2012 to December 2014 were reviewed, retrospectively. Results Totally 1 245 strains of bacteria were isolated. The department distributed widely in department of pulmonary disease, which accounted for 65.14%. The specimens were mainly obtained from the sputum and throat swab. The drug resistance rate of K. pneumoniae against ampicillin was up to 98.96%, followed by piperacillin, cefazolin/ceftriaxone. The drug resistance rates of K. pneumoniae against imipenem, meropenem, and piperacillin-tazobactam/cefoperazone-sulbactam were low. The drug resistance rate of ESBLs positive K. pneumoniae to antibacterial drugs was significantly higher than that of the ESBLs negative strains except for imipenem, meropenem, cefepime, and ampicillin. Conclusion Multiple drug resistance of K. pneumoniae is serious, and there is an upward trend in resistance to common antibacterial drugs. Therefore clinic should reasonably use antibacterial drugs based on the results of drug susceptibility test.

國(guó)家自然科學(xué)基金資助項(xiàng)目(81373849)