肺炎克雷伯菌院感分布及耐药性分析
摘要：目的分析该院2015年1月-2016年12月临床分离的肺炎克雷伯菌（Kpn）的分布情况及耐药性，指导临床合理用药，控制肺炎克雷伯菌的医院感染。方法：对临床分离出来的286株肺炎克雷伯菌进行标本，科室分布的统计及
耐药性分析，并对其中多重耐药肺炎克雷伯菌作ESBLs，AmpC酶，碳青霉烯酶，
新德里金属β内酰胺酶（NDM-1）等试验。结果286株肺炎克雷伯菌主要来自
痰液，占79.72%（228/286），其次为尿液及伤口分泌物，分别占8.74%
（25/286），5.59%（16/286）；主要分布于ICU，呼吸内科，分别占56.29%
（161/286），27.62%（79/286），产ESBLs肺炎克雷伯菌检出162株，检出率为56.64%（162/286），产AmpC酶检出39株，检出率为13.64%（39/286），产KPC酶28株，检出率为9.79%（28/286），产NDM-1检出2株，检出率为0.70%（2/286）。结论该院肺炎克雷伯菌主要分离自痰标本，以ICU感染最为严重，其次为呼吸内科，肺炎克雷伯菌的耐药率比较高，且耐药表型多样，对多重耐药
株检测耐药机制非常重要，以便控制医院的感染。
关键词：多重耐药肺炎克雷伯菌；超广谱β-内酰胺酶；药敏试验；医院感染
Distribution and drug resistance analysis of nosocomial infection of
Klebsiella pneumoniae
Xiao Qi-guo Tang Mei-hua（Department of Clinical laboratory，Central Hospital
of Hengyang City，Hunan 421001，China）
【Abstract】Objective To analyze the distribution and drug resistance of Klebsiella pneumoniae（Kpn）isolated from clinical patients in the hospital during January 2015 to December 2016，and to guide rational drug use in clinic and control nosocomial infection of Klebsiella pneumoniae.Method A total of 286 strains of Klebsiella pneumoniae isolated from clinical patients were collected，the specimen Department Distribution and drug resistance were analyed.ESBLs，AmpCenzyme，carbapenemase and NDM-1enzymes tests were carried out with multidrug resistant Klebsiella pneumoniae.Results The 286 strains of Klebsiella pneumoniae were mainly isolated from sputum，accounting for 79.72%（228/286），followed by urine and wound secretions，accounting for 8.74%（25/286）and 5.59%（16/286）respectively；The strains were Mainly distributed in ICU and respiratory medicine department，accounting for 56.29%（161/286）and 27.62%（79/286）respectively，162 strains producing ESBLs Klebsiella pneumoniae were detected，the detection rate was 56.64%（162/286），39 strains producing AmpC enzyme were detected，the detection rate was 13.64%（39/286），28 strains producing KPC enzyme were detected，the detection rate was 9.79%（28/286），2 strains producing NDM-1 enzyme were detected，the detection rate was 0.70%（2/286）.Conlusion Klebsiella pneumoniae was mainly isolated from sputum specimens in the hospital，most seriously infected was ICU，followed by respiratory medicine department，the resistance rate of Klebsiella pneumoniae was relatively high，and the phenotype of drug resistance was diverse.It is very important to detect the mechanism of multidrug resistance in order to control nosocomial infection.
【Key words】 Multi drug resistant Klebsiella pneumoniae Extended spectrum beta lactamases Drug sensitivity test nosocomial infection
