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目的分析医院肺炎克雷伯菌的标本来源及对常用抗菌药物的耐药性变迁,为临床医师合理选用抗菌药物提供依据。方法从2013年-2015年连续3年医院临床科室送检的各类标本中分离致病菌,采用法国生物梅里埃公司的VITEK 2 Compact全自动细菌鉴定药敏分析仪对所分离菌株进行细菌鉴定和药敏试验,用WHONET 5.6软件对所有数据进行统计分析。结果肺炎克雷伯菌主要分离自痰及呼吸道分泌物、中段尿和血液;2013年-2015年该菌对复方新诺明的耐药率最高,依次为53.1%、46.2%和48.6%;对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南和美罗培南的耐药率较低。结论肺炎克雷伯菌的临床标本来源没有明显变化,对各类抗菌药物呈现不同形势的耐药性变迁。应加强细菌耐药性监测,合理选用抗菌药物,防止多重耐药菌的产生。
Objective To analyze the source of Klebsiella pneumoniae in hospital and the change of drug resistance to commonly used antimicrobial agents, so as to provide basis for clinicians to choose antibacterial drugs reasonably. Methods Pathogenic bacteria were isolated from all kinds of specimens submitted by clinical departments of the hospital for three consecutive years from 2013 to 2015. The bacteria were identified by VITEK 2 Compact automatic bacterial identification antimicrobial susceptibility analyzer And susceptibility testing, using WHONET 5.6 software for statistical analysis of all data. Results Klebsiella pneumoniae was mainly isolated from sputum and respiratory secretions, middle urine and blood. The highest rate of resistance to cotrimoxazole from 2013 to 2015 was 53.1%, 46.2% and 48.6%, respectively. Piperacillin / tazobactam, cefoperazone / sulbactam, imipenem and meropenem had lower rates of resistance. Conclusion Klebsiella pneumoniae clinical specimens of no significant changes in the source of various types of antimicrobial agents showed different situations of drug resistance changes. Should strengthen the monitoring of bacterial resistance, rational use of antimicrobial agents, to prevent the generation of multi-resistant bacteria.