医院感染肺炎克雷伯菌与大肠埃希菌的分布差异及耐药分析

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Abstract Objective To compare and analyze the differences between clinical isolates of Escherichia coli and Klebsiella pneumoniae, including sensitivity, specimen type separation and department distribution, so as to fully understand the drug resistance of the two main pathogens. Methods BioMerieux VITEK2 Compact automatic bacterial identification and drug sensitivity analysis system were used for bacterial identification and drug sensitivity test, and Excel software was used for data analysis. Results In 2020, 1614 strains of Escherichia coli and 579 strains of Klebsiella pneumoniae were clinically isolated, and more than half of them were isolated from urine, but there was no significant difference among different samples of Klebsiella pneumoniae. The number of Klebsiella pneumoniae isolated from respiratory tract samples was much more than that of Escherichia coli. There was no statistically significant difference between the two isolates in intensive care unit (ICU), but there was statistically significant difference in other departments. There was statistically significant difference in the detection rate of ESBLs (-) strain between the two strains (P＜0.05), but there was no statistically significant difference in the detection rate of ESBLs (-) strain (P＞0.5).The susceptibility rate of Escherichia coli to imipenem was 98.9%, while that of Klebsiella pneumoniae was 82.4%,especially in ICU, the susceptibility rate was as low as 59.5%. The susceptibility rate of Klebsiella pneumoniae isolated from sputum to imipenem was 64.8%. Four out of 102 strains of Imipenam -resistant Klebsiella pneumoniae were susceptible to tronem, while 10 out of 17 strains of imipenam-resistant Escherichia coli were susceptible to tronem. Conclusion Both Escherichia coli and Klebsiella pneumoniae are resistant to carbapenems, especially Klebsiella pneumoniae, and their carbapenemase producing types are different. Klebsiella pneumoniae is less sensitive to most antibiotics than Escherichia coli, except levofloxacin. The drug resistance problem is particularly serious in ICU, and the sensitivity of isolates isolated from whole blood is good,but that from sputum is poor.

Key words： Escherichia coli Klebsiella pneumoniae Extended spectrum β-lactamases AmpC Carbapenemases

Received: 16 June 2021

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