大理学院附属医院大肠埃希菌和肺炎克雷伯菌耐药性研究

目的：对大理学院附属医院2011年至2012年临床分离的大肠埃希菌及肺炎克雷伯杆菌的耐药性进行分析,指导临床合理应用抗生素。方法：菌株分离及培养按常规方法进行,细菌鉴定采用VITET-2 Compact 60全自动微生物分析仪,药敏试验采用K-B法。结果：共收集标本183株,其中大肠埃希菌146株：口痰92株（63%）、分泌物17株（11.6%）、尿液16株（10.9%）,脓液9株（6.1%）,其他12株（8.2%）;肺炎克雷伯杆菌37株：口痰27株（73%）、分泌物5株（13.5%）、脓液3株（8%）其他2株（5.4%）。药敏试验结果显示：大肠埃希菌和肺炎克雷伯杆菌对头孢哌酮、阿米卡星、亚胺培南等耐药率较低,分别为10.3%、6.2%、2.7%和10.8%、13.5%、2.7%。结论：大肠埃希菌及肺炎克雷伯杆菌两年痰液中检出率呈上升趋势,对左氧氟沙星、头孢唑啉,氨曲南,头孢他啶等耐药率超过50%,特别是头孢他啶的耐药率相对于2008年显著升高,而对头孢哌酮、阿米卡星、亚胺培南等耐药性较低,临床应根据药敏实验合理选择抗生素。

Analysis of Resistance of Escherichia Coli and Klebsiella Pneumoniae in Affiliated Hospital of Dali University

Objective： To instruct the clinical medicine in Affiliated Hospital of Dali University by analyzing the resistance of Escherichia coli and Klebsiella pneumoniae from 2011 to 2012. Methods： Isolate and culture strains by using conventional methods, and identify the bacteria with VITET-2 Compact 60 automatic microbial analyzer and test the susceptibility through K-B. Results： In total 183 specimens, 146 of them were Escherichia coli： koutan 92 （63%）, secretions 17 （11.6%）, urine 16 （10.9%）, pus 9 （6.1% 2）, other 12 （8.2%）; 37 of them were Klebsiella pneumoniae： koutan 27 （73%）, secretions five （13.5%）, pus 3 （8%）, other susceptibility test results： the resistance rates of Cefoperazone, Amikacin, Imipenem were lower, at 10.3%, 6.2%, 2.7% and 10.8%, 13.5%, 2.7%, respectively. Conclusion： The detection rate of Escherichia coli and Klebsiella pneumoniae in sputum is rising in these two years, and the resistance rates have been exceeded more than 50% of levofloxacin, cefazolin, aztreonam, ceftazidime, especially ceftazidimewas resistance rates is significantly elevated. However, resistance rates of cefoperazone, amikacin, imipenem are lower, so doctors should choose antibiotics based on susceptibility experiments.