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目的分析南京高淳地区2012-2016年肺炎克雷伯菌对抗菌药物耐药性的变迁情况,为指导临床合理使用抗菌药物提供依据[1]。方法对临床各种标本分离的肺炎克雷伯菌进行微量稀释法进行试验,回顾的对其耐药实验结果进行分析。结果头孢类药物对肺炎克雷伯菌耐药性逐年增加,头孢唑林、头孢吡亏近年来耐药性迅速上升,头孢他啶由于近年来使用减少,其耐药性波动也有所抑制。喹诺酮类药物由于具有抗菌谱广、杀菌力强、作用迅速、体内分布广泛及与其他抗生素之间无交叉耐药性等特点,临床广泛使用导致最近几年耐药率明显上升。碳青酶烯类抗生素对绝大多数β-内酰胺酶稳定,因此,一直以来都是治疗肺炎克雷伯菌的最有效抗生素。结论随着抗生素的滥用,该地区肺炎克雷伯菌对常见抗菌药物耐药率高,耐药形势依旧严峻,肺炎克雷伯菌耐药率与抗菌药物的用量存在一定相关性,本研究对临床用药有着一定指导作用,临床应合理控制和延缓耐药菌的增长。
Objective To analyze the change of antimicrobial resistance of Klebsiella pneumonia from 2012 to 2016 in Gaochun area of Nanjing, and to provide basis for clinical rational use of antimicrobial agents [1]. Methods Klebsiella pneumoniae isolated from clinical samples were tested by microdilution method, and the results of drug resistance test were analyzed retrospectively. Results The antibiotic resistance of cephalosporins to Klebsiella pneumoniae increased year by year. The resistance of cefazolin and ceftazidime increased rapidly in recent years. As the use of ceftazidime decreased in recent years, the fluctuation of drug resistance was also inhibited. Quinolones have been widely used in recent years because of their broad antibacterial spectrum, strong bactericidal effect, rapid action, wide distribution in vivo and no cross-resistance with other antibiotics. Carbapenems are the most potent antibiotics for the treatment of Klebsiella pneumoniae because they are stable to most β-lactamases. Conclusions With the abuse of antibiotics, Klebsiella pneumoniae in this area has high resistance rate to common antibiotics and the drug resistance situation is still grim. There is a certain correlation between the drug resistance rate of Klebsiella pneumoniae and the dosage of antibiotics. Clinical medication has a guiding role, should be a reasonable clinical control and delay the growth of resistant bacteria.