临床病例痰液和腹泻病例粪便标本来源的肺炎克雷伯菌分离株的耐药特征分析

目的分析2013~2016年临床来源的60株肺炎克雷伯菌的药敏特征。方法参考美国临床实验室标准化委员会推荐的微量肉汤稀释法,研究肺炎克雷伯菌对13类27种抗生素的耐药情况。结果 60株肺炎克雷伯菌中有57株耐药,总耐药率95.0%,其中48株来自痰液标本,9株来自粪便标本,共有38个耐药谱。耐药株对氨苄西林、头孢噻肟、头孢噻呋、阿莫西林/克拉维酸耐药率较高,分别为93.3%、66.7%、65.0%和60.0%。痰标本分离的48株肺炎克雷伯耐药菌有36种耐药谱,主要的耐药谱特征为AMP-CHL-AMC-CTX-CAZ-NALCIP-FEP-IPM-FOX-ATM-MEM-EFT-LEV-AMK-GEN-AZM-KAN(n=6),9株腹泻粪便标本耐药株有3种耐药谱,主要的耐药谱为AMP(n=7)。10株(10/57,17.5%)产超广谱β-内酰胺酶(extended-spectrumβ-lactamases,ESBLs)菌株均来自痰标本分离株。结论分离自痰液标本的肺炎克雷伯菌菌耐药率高,且多重耐药情况严重,应加强对该来源菌株的监测。

Drug resistant analysis of Klebsiella Pneumoniae isolated from clinical specimens of diarrhea stool and sputum

Objective To analyze the drug sensitive characteristics of 60 strains of clinical Klebsiella Pneumoniae from 2013 to 2016. Methods The microbroth dilution method recommended by the standardization committee of the American clinical laboratory was conducted, and the resistance of Klebsiella Pneumoniae to 13 classes of 27 antibiotics was studied. Results Among the 60 strains of Klebsiella Pneumoniae, 57 strains were resistant to the drug, and the total resistance rate was 95.0%, 48 strains were from sputum samples, 9 strains from fecal specimens, and there were 38 strains resistance spectrum. Resistant strains were higher in ampicillin, cefotaxime, cefotioxi, amoxicillin/clavic acid resistance, at 93.3%, 66.7%, 65.0% and 60.0%, respectively. 48 drug-resistant strains isolated from sputum specimens had a total of 36 drug resistant spectrums, and the main type was AMP-CHL-AMC-CTX-CAZ-NAL-CIP-FEP-IPM-FOX-ATM-MEM-EFT-LEV-AMK-GEN-AZM-KAN (n=6). Nine drug-resistant strains isolated from diarrhea stool specimens had a total of 3 drug resistant spectrums, and the main type was AMP (n=7). All of 10 (10/57, 17.5%) ESBLs positive strains were isolated from sputum specimens. Conclusion The resistant rate of Klebsiella Pneumoniae strains isolated from sputum specimens is very high, and multi-drug resistant situation is serious. These show that we should strengthen the monitoring of Klebsiella Pneumoniae.