摘要
目的分析2017~2018年黑龙江地区某院肿瘤呼吸道感染患者送检痰标本中分离肺炎克雷伯菌的临床分布及耐药情况,为指导临床医生合理应用抗菌药物,降低细菌耐药率提供依据。方法对2017~2018年黑龙江地区某院肿瘤患者送检的痰标本中分离肺炎克雷伯菌进行细菌鉴定及药敏试验,对其临床科室分布情况及对临床常用抗菌药物的耐药特征进行分析。结果2017~2018年黑龙江地区某院肿瘤患者呼吸道感染检出肺炎克雷伯菌1473株,其中临床科室以胸外科(668/1473)检出率最高,其次为胃肠外科(184/1473)。2年间肺炎克雷伯菌对碳青霉烯类抗菌药物、头孢哌酮/舒巴坦及阿米卡星保持较高的敏感性,耐药率均低于2%。2017、2018年产超广谱β-内酰胺酶(extended spectrum beta-lactamases,ESBLs)的肺炎克雷伯菌分别占15.34%、14.16%,产ESBLs菌株对常用抗菌药物的耐药率均明显高于非产ESBLs菌株(P<0.001)。两年间碳青霉烯类抗菌药物耐药率为0.34%,除对庆大霉素、复方新诺明、环丙沙星、四环素及左旋氧氟沙星耐药率无差异以外,碳青霉烯类抗菌药物耐药菌株对其它15种抗菌药物的耐药率均明显高于敏感菌株(P<0.001)。结论耐碳青霉烯类菌株对阿米卡星、左旋氧氟沙星、复方新诺明及四环素尚有一定的敏感性,可作为临床碳青霉烯类耐药菌株抗感染治疗药物使用。
Objective To investigate the distribution and antimicrobial resistance profile of Klebsiella pneumoniae isolated from cancer patients with respiratory tract infection in 2017 to 2018,and provide evidence for rational use of antibiotics to reduce the antibiotic resistance rates.Methods A retrospective analysis was carried out with 1473 K.pneumoniae from sputum samples of cancer patients with respiratory infection during 2017 to 2018.The clinical distribution and drug-resistance features were analyzed through the microbiology laboratory database.Results A total of 1473 K.pneumoniae were consecutively collected from sputum samples of cancer patients with respiratory infection during 2017 to 2018 in Heilongjiang province.The infection mainly occurred in thoracic surgery department(668/1473),followed by gastrointestinal surgery department(184/1473).K.pneumoniae maintained high sensitivity to carbapenem antibiotics,cefoperazone/sulbactam and amikacin during 2 years,with the drug resistance rates less than 2%.From 2017 and 2018,the extended spectrum Beta-Lactamases(ESBLs)producing K.pneumoniae was accounted for 15.34%and 14.16%respectively.The resistance rates of ESBLs producing K.pneumoniae were significantly higher than that of non-ESBLs producing isolates(P<0.001).The drug resistance rate of carbapenem antibiotics was 0.34%during the two years.Carbapenem-resistant K.pneumoniae were resistant to most antibiotics(P<0.001)except for gentamicin,sulfamethoxazole,ciprofloxacin,tetracycline and levofloxacin.Conclusion Carbapenem-resistant K.pneumoniae are sensitive to amikacin,levofloxacin,sulfamethoxazole and tetracycline,which have the potential to be used for clinical practice.
作者
关洁
俞晓晨
于文竹
宋桓宇
张明岩
王连明
GUAN Jie;YU Xiao-chen;YU Wen-zhu;SONG Huan-yu;ZHANG Ming-yan;WANGLian-ming(Department of Clinical Laboratory,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China;Department of Clinical Laboratory,The Affiliated Cancer Hospital of Harbin Medical University,Harbin 150081,China)
出处
《哈尔滨医科大学学报》
CAS
2019年第6期602-607,共6页
Journal of Harbin Medical University
