Samad Abdul, Ahmed Tanveer, Rahim Afaq, Khalil Abdul, Ali Iftikhar
Prof. Abdul Samad, FRCP, Department of Medicine & Allied, Northwest General Hospital & Research Centre, Peshawar, Khyber Pakhtunkhwa, Pakistan.
Dr. Tanveer Ahmed, MBBS, Department of Medicine & Allied, Northwest General Hospital & Research Centre, Peshawar, Khyber Pakhtunkhwa, Pakistan.
Pak J Med Sci. 2017 May-Jun;33(3):670-674. doi: 10.12669/pjms.333.12416.
This study aims to determine the prevalence and susceptibility pattern of and multidrug-resistant (MDR) isolates in patients suffering from respiratory tract infection.
A cross sectional study was conducted from January to December 2014 in Northwest General Hospital and Research Centre, Peshawar. A total of 615 sputum samples were collected from both in and out-patients. Sputum samples were collected as per standard procedure and were inoculated on Blood, MacConkey and Chocolate agar. The isolates were identified by standard protocols using biochemical tests. The antibiotic susceptibility pattern of each isolate was checked as per Clinical and Laboratory Standards Institute (CLSI) guidelines using disc diffusion method.
Out of 615 sputum samples, 354 (57.56%) were culture positive. Out of these a total of 71 (20.05%) strains of were isolated, where 54.93% was from males and 45.07% were from females (Mean age was 44.29 ± 22.72:). Highest sensitivity was seen to Amikacin (92.86%) followed by Meropenem (91.55%) while lowest sensitivity was seen to Cefoperazone + Sulbactam (16.9%). There were 39.44% MDR strains, out of which 25% were Extensively Drug Resistant (XDR) and 10.71% were Pan Drug Resistant (PDR). In vitro susceptibility of MDR isolates showed highest sensitivity to Amikacin (82.14%) followed by Carbapenems (78.57%). All MDR isolates were resistant to Cefoperazone + Sulbactam. Resistance to Piperacillin + Tazobactam was 96.43%.
is one of the commonly isolated organisms and it is becoming more resistant to commonly used antibiotics. Carbapenems and aminoglycosides were the two classes of drugs that showed highest activity against .
本研究旨在确定呼吸道感染患者中肺炎克雷伯菌及多重耐药（MDR）菌株的流行情况和药敏模式。
2014年1月至12月在白沙瓦西北综合医院及研究中心开展了一项横断面研究。共从门诊和住院患者中收集了615份痰标本。按照标准程序收集痰标本，并接种于血琼脂、麦康凯琼脂和巧克力琼脂上。使用生化试验通过标准方案鉴定分离株。根据临床和实验室标准协会（CLSI）指南，采用纸片扩散法检查每个分离株的抗生素药敏模式。
在615份痰标本中，354份（57.56%）培养阳性。其中共分离出71株（20.05%）肺炎克雷伯菌，其中54.93%来自男性，45.07%来自女性（平均年龄为44.29±22.72岁）。对阿米卡星的敏感性最高（92.86%），其次是美罗培南（91.55%），而对头孢哌酮+舒巴坦的敏感性最低（16.9%）。有39.44%的多重耐药菌株，其中25%为广泛耐药（XDR），10.71%为全耐药（PDR）。多重耐药分离株的体外药敏显示对阿米卡星的敏感性最高（82.14%），其次是碳青霉烯类（78.57%）。所有多重耐药分离株均对头孢哌酮+舒巴坦耐药。对哌拉西林+他唑巴坦的耐药率为96.43%。
肺炎克雷伯菌是常见的分离菌之一，且对常用抗生素的耐药性越来越强。碳青霉烯类和氨基糖苷类是对肺炎克雷伯菌活性最高的两类药物。
