耐碳青霉烯类药物肺炎克雷伯菌和鲍曼不动杆菌对替加环素的敏感性分析

doi:10.3969/j.issn.1671-2587.2020.01.015

临床输血与检验 ›› 2020, Vol. 22 ›› Issue (1): 64-67.DOI: 10.3969/j.issn.1671-2587.2020.01.015

耐碳青霉烯类药物肺炎克雷伯菌和鲍曼不动杆菌对替加环素的敏感性分析

周丹, 钟平

431600 孝感,湖北省汉川市人民医院检验科

收稿日期:2018-06-04 出版日期:2020-02-20 发布日期:2020-02-28
通讯作者: 钟平,女,主管技师,主要从事医学检验微生物工作,(E-mail)zhou20101121@163.com。
作者简介:周丹(1973-),女,湖北孝感人,副主任技师,学士,主要从事临床检验工作,(E-mail)1090610445@qq.com。

The Sensitivity of Carbapenem-Resistant Klebsiella Pneumoniae and Acinetobacter Baumannii to Tigecycline

ZHOU Dan, ZHONG Ping

Hanchuan Hospital of Hubei Province,Xiaogan,Hubei 431600

Received:2018-06-04 Online:2020-02-20 Published:2020-02-28

摘要/Abstract

摘要： 目的分析耐碳青霉烯类药物肺炎克雷伯菌和鲍曼不动杆菌对替加环素的敏感性,为临床控制耐碳青霉烯类药物病菌繁殖提供理论依据。方法收集2016年12月~2017年12月本院住院患者送检标本中分离出来的耐碳青霉烯类药物肺炎克雷伯菌112株和耐碳青霉烯类药物鲍曼不动杆菌98株,比较耐碳青霉烯类药物肺炎克雷伯菌和鲍曼不动杆菌对各类抗菌药物的耐药性差异。结果耐碳青霉烯类药物的肺炎克雷伯菌和鲍曼不动杆菌几乎对所有抗菌类药物都有较强的耐药性;耐碳青霉烯类药物肺炎克雷伯菌对替加霉素的敏感菌数为97株,占86.61%,而耐碳青霉烯类药物鲍曼不动杆菌对替加霉素的敏感菌数为68株,占69.39%,替加环素对肺炎克雷伯菌的敏感性明显优于鲍曼不动杆菌,差异有统计学意义(χ2=14.034,P=0.001);当MIC为4 mg/L时耐碳青霉烯类肺炎克雷伯菌的敏感率为100.00%,而碳青霉烯类鲍曼不动杆菌敏感率为71.21%,替加环素对两类菌体外敏感率分布差异有统计学意义(χ2=18.488,P=0.002)。结论耐碳青霉烯类药物肺炎克雷伯菌对替加环素的敏感性明显高于耐碳青霉烯类药物鲍曼不动杆菌,所以临床上采用替加环素可以有效控制耐碳青霉烯类肺炎克雷伯菌。

关键词: 耐碳青霉烯类, 肺炎克雷伯菌, 鲍曼不动杆菌, 替加环素

Abstract: Objective To analyze the sensitivity of carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii to tigecycline so as to provide an evidence for control of carbapenem-resistant bacteria neumonia. Methods One hundred and twelve specimens of carbapenem-resistant K.pneumoniae and 98 specimens of A.baumannii were collected in the hospital from 2016 to 2017. All of the isolates exhibited a broad spectrum antibiotic resistance. Results Ninety of 112 isolates (86.61%) of K.pneumoniae showed their sensitivity to tigecycline whereas 68 of 98 (69.39%) isolates of A.baumannii showed the sensitivity to tigecycline, demonstrating a higher sensitivity of K.pneumoniae to tigecycline than that of A.baumannii (P=0.001). All strains of carbapenem-resistant K.pneumoniae were found to be sensitive to tigecycline at MIC 4 mg/L when compared with A.baumannii that showed 71.21 percent of sensitivity (χ2=18.488, P=0.002). Conclusion Carbapenem-resistant K.pneumoniae has a higher antibiotic sensitivity to tigecycline than A.baumannii, suggesting a choice of use of tigecycline in control of pneumonia.

Key words: Carbapenem-resistance, Klebsiella pneumoniae, Acinetobacter baumannii, Tigecycline

中图分类号:

R378
R969.3

周丹, 钟平. 耐碳青霉烯类药物肺炎克雷伯菌和鲍曼不动杆菌对替加环素的敏感性分析[J]. 临床输血与检验, 2020, 22(1): 64-67.

ZHOU Dan, ZHONG Ping. The Sensitivity of Carbapenem-Resistant Klebsiella Pneumoniae and Acinetobacter Baumannii to Tigecycline[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2020, 22(1): 64-67.

参考文献

1 刘妍,袁应华.耐碳青霉烯类药物肺炎克雷伯菌和鲍曼不动杆菌对替加环素的敏感性及药物敏感性试验的临床应用[J].检验医学,2018,33(2):147-151.
2 陈爱凤,沈晓强,丁士标,等.替加环素治疗碳青霉烯类耐药肺炎克雷伯菌肺炎的临床疗效及预后分析[J].浙江医学,2018,40(3):258-261.265.
3 史玮炀,刘洋,韩逸超,等.耐碳青霉烯类肺炎克雷伯菌的分子流行病学分析[J].检验医学,2018,33(1):37-43.
4 Hossan M S,Jindal H,Maisha S,et al.Antibacterial effects of 18 medicinal plants used by the Khyang tribe in Bangladesh[J]. Pharm Biol,2018,56(1):201-208.
5 刘晓慧,刘世坤,何鸽飞,等.8例NSICU耐碳青霉烯-肺炎克雷伯菌感染的治疗分析[J].中国医院药学杂志,2018,38(2):185-188.
6 毕树英,樊春凤,范桂华,等.重症监护病房660株阳性菌株分布及药敏分析[J].现代医药卫生,2017,33(22):3416-3419.
7 牛晓娜,陈香丽,郭建民.头孢吡肟联合替加环素治疗克雷伯菌肺炎的临床研究[J].现代药物与临床,2017,32(11):2141-2144.
8 钟雪,陈东科,许宏涛,等.替加环素对肺炎克雷伯菌的防耐药突变浓度研究[J].中国感染与化疗杂志,2017,17(6):643-647.
9 Palmieri M,Schicklin S,Pelegrin AC,et al.Phenotypic and Genomic Characterization of AmpC-Producing Klebsiella pneumoniae From Korea[J]. Ann Lab Med,2018,38(4):367-370.
10 刘洋,郑丹丹,韩逸超,等.多重耐药肺炎克雷伯菌感染的危险因素及治疗方案比较[J].上海交通大学学报(医学版),2017,37(7):973-977.
11 郭艳玲,班武娟,时广利,等.2013—2015年某结核病专科医院常见病原菌分布及耐药监测分析[J].国际检验医学杂志,2017,38(11):1473-1476.1479.
12 Gabriel I,Olejek A,Stencel-Gabriel K,et al.The influence of maternal vaginal flora on the intestinal colonization in newborns and 3-month-old infants[J]. J Matern Fetal Neonatal Med,2018,31(11):1448-1453.
13 郑敬,苑鑫,刘永辉,等.替加环素联合治疗泛耐药肺炎克雷伯菌菌血症病例分析[J].中国临床药理学杂志,2017,33(8):742-744.
14 毛文炜,周华,杨青,等.耐亚胺培南肺炎克雷伯菌腹腔感染患者的临床特征及预后[J].中国微生态学杂志,2017,29(2):166-170.
15 陈宏斌,赵春江,王辉,等.2007-2013年医院内获得性肺炎病原菌分布及其耐药性分析[J].中华医院感染学杂志,2017,27(1):1-7.15.
16 贺吉童,倪文涛,王睿,等.多黏菌素联合用药治疗产肺炎克雷伯菌碳青霉烯酶肺炎克雷伯菌体外研究进展[J].中国临床药理学杂志,2016,32(24):2315-2318.
17 谢悦良,刘晶晶,吴翠芳,等.耐碳青霉烯类肺炎克雷伯菌肺部感染伴肾清除率增加患者的药学监护[J].中国临床药理学与治疗学,2016,21(10):1149-1154.
18 白艳,柴栋,李晨,等.碳青霉烯类耐药肺炎克雷伯菌的联合用药的文献计量分析[J].中国临床药理学杂志,2016,32(5):462-465.
19 何建新,吴荣辉,金小珍.替加环素、米诺环素、多黏菌素B对碳青霉烯类敏感性降低和不敏感肺炎克雷伯菌的体外抗菌活性[J].浙江医学,2015,37(21):1761-1763.
20 Ferreira JC,Penha Filho RAC,Kuaye APY,et al.Identification and characterization of plasmid-mediated quinolone resistance determinants in Enterobacteriaceae isolated from healthy poultry in Brazil[J]. Infect Genet Evol,2018,60:66-70.
21 Gu Q H,Xie L J,Jia X Y,et al.Fever and prodromal infections in anti-glomerular basement membrane disease[J]. Nephrology (Carlton),2018,23(5):476-482.
22 游琨,王芬,罗欲承,等.肺炎克雷伯菌在ICU与非ICU病区分布及耐药性监测[J].实验与检验医学,2015,33(1):90-92.

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耐碳青霉烯类药物肺炎克雷伯菌和鲍曼不动杆菌对替加环素的敏感性分析

The Sensitivity of Carbapenem-Resistant Klebsiella Pneumoniae and Acinetobacter Baumannii to Tigecycline

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