| 摘要: |
| 目的：回顾性分析呼吸道肺炎克雷伯菌感染的耐药特点，为抗生素的合理用药提供指导意见。方法：我院儿科病房呼吸道感染住院患儿68例，经痰拭子、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：绍兴市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。 |
| 关键词: 儿童 呼吸道疾病 超广谱β-内酰胺酶 肺炎克雷伯菌 耐药性 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.02.017 |
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| 基金项目: |
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| Resistance Characteristics and Significance of Klebsiella Pneumoniae in Children |
| Wang Yingying |
| (Shaoxing Central Hospital of Zhejiang Province, Zhejiang Shaoxing 312030, China) |
| Abstract: |
| Objective: To retrospectively analyze resistance characteristics of Klebsiella pneumoniae respiratory tract infection, to provide guidance for rational use of antibiotics. Methods: 68 cases of children with respiratory tract infection hospitalized pediatric ward, Klebsiella pneumoniae 88 plants were isolated by sputum swabs, blood, urine, endotracheal intubation end sample, Klebsiella pneumoniae resistance and sensitivity was analyzed by K-B method (disk diffusion method), extended-spectrum β-lactamases (ESBLs) were screened referring to NCCLS standard. Results: Producing extended-spectrum β-lactamases (ESBLs), the highest rates was Klebsiella pneumoniae resistant to cefotaxime, amounting to 88.6 %, followed by cefuroxime, ceftazidime, ceftriaxone and ampicillin/sulbactam. Meropenem, imipenem, ciprofloxacin, cefoperazone/sulbactam, ceftazidime/clavulanic acid, sensitive to cefotaxime/clavulanic acid was 100%. Conclusion: The sensitivity of pediatric respiratory pathogen Klebsiella pneumoniae infection for cephalosporin antibiotic is higher, primarily related to the formation of ESBLs-producing bacteria, and sensitivity to meropenem, imipenem, ciprofloxacin and other than high, should be reasonable in clinical medicine, prevention of ESBLs gram-negative bacteria epidemic. |
| Key words: Children Respiratory disease Extended-spectrum β- lactamase Klebsiella pneumonia Resistant |
