Resistance Surveillance Of Klebsiella Pneumoniae In A General Hospital Of Chongqing From2009to2011

Objective：To investigate the resistance of clinical isolates of Klebsiellapneumoniae from Jan2009to Dec2011in a general hospital of Chongqing，and provide a reference for clinical treatment. Methods：Disk diffusion testwas used to study the antimicrobial agents resistance. The Results wasevaluated based on Clinical and Laboratory Standards Instisute. WHONET5.4were used to analyze the data. Results：During the past three years,535strains of Klebsiella pneumoniae were separated from all of the clinicalsamples, including94Klebsiella pneumoniae Extended spectrumβ-lactamases (ESBLs)-producing strains, which rate was17.57%. From2009to2011, The resistance rate of the isolated strains of Klebsiellapneumoniae to piperacillin was all more than40%, to amikacin it was all lessthan10%.2009and2011, the resistance rate to cefoxitin,cefoperazone/sulbactam, piperaeillin/tazobactam, were all less than10%.The resistance rates to carbapenemase was all less than4%. Compared with2009and2011, the resistance rates of the isolated strains in2010to thecefoxitin, beta-lactamase inhibitors, carbapenemas, it was obviously higher than that in2009and2011. The detection rate of ESBL-producing Klebsiellapneumoniae to2009,2010,2011,was lower and lower. In all of theKlebsiella pneumoniae, there have17isolates resistant to carbapenemase.The resistance rate of the carbapanem-resistant strains were obviouslyhigher than non-carbapanem-resistant strains. Conclusion：To the Klebsiellapneumoniae infections, except piperacillin and the third and fourthcephalosporin we should considerd carefully, carbapenemase、beta-lactamase inhibitors、amikacin、ciprofloxacin all could be selected. Tothe ESBL-producing isolates, it suggest that don’t choose piperacillin andthe third and fourth cephalosporin, and to combine with the antimicrobialsusceptibility test and the severity of the infection, rational choosingantimicrobial drugs mono or combination therapy.