非产超广谱β-内酰胺酶肺炎克雷伯杆菌的耐药性分析

目的了解临床分离肺炎克雷伯杆菌中非产超广谱β-内酰胺酶（ESBLs）菌株对18种常见抗菌药物的耐药性。方法CLSI表型确证试验-纸片增强法检测非产ESBLs肺炎克雷伯菌，K-B法测定非产ESBLs肺炎克雷伯杆菌对18种常见抗菌药物的敏感性。结果非产ESBLs肺炎克雷伯杆菌株对头孢唑啉、头孢呋辛的耐药率〉50．0％，对其余抗生素的耐药率均低于25．0％，对亚胺培南、美罗培南非常敏感，耐药率分别为2．3％和2．0％；痰标本的分离株对头孢唑啉、头孢呋辛的耐药率明显高于血、尿液标本分离株，差异有统计学意义（P〈0．05）。结论非产ESBLs肺炎克雷伯杆菌对第一、二代头孢菌素耐药显著，对第三代头孢菌素、亚胺培南、美罗培南等抗生素比较敏感。

Antibiotics resistance of non-ESBLs-producing Klebsiella pneumoniae isolates

Objective To investigate the resistance of non-ESBLs-producing Klebsiella pneumoniae isolates to 18 kinds of antibiotics.Method Non-ESBLs producing Klebsiella pneumoniae isolates were detected by CLSI phenotypic confirmatory test,and susceptibility of these isolates to 18 kinds of antibiotics was tested by Kirby-Bauer method.Result The resistance rate of these isolates to Cefazolin and Cefoxime was higher than 50% and that to others was lower than 25.0%.The non-ESBLs producing Klebsiella pneumoniae were sensitive to Imipenem and Meropenem,and their resistance rates to Imipenem and Meropenem were 2.3% and 2.0%,respectively.The resistance rate of the isolates from sputum samples to Cefazolin and Cefoxime was significantly higher than those from blood,urine(P<0.05).Conclusion Most isolates of non-ESBLs-producing Klebsiella pneumoniae are resistant to the first and second generation cephalosporins,while susceptible to meropenem,the third generation cephalosporins and other antibiotics.