Wang Y Q, Wang F, Zhu D M
Institute of Antibiotics, Huashan Hospital, Shanhai Medical University.
Zhonghua Yi Xue Za Zhi. 1995 Feb;75(2):88-91, 126.
Ninety-four percent of 336 strains of Klebsiella pneumoniae were resistant to ampicillin, while less than 10% were resistant to cefotaxine and ceftazidine. Among all the aminoglycosides tested, amikacin had the strongest activity on K. pneumoniae. The resistant rate of nosocomial strains was higher than that of community strains. The results of susceptibility test showed that 42% (119/280) of K. pneumoniae strains were gentamicin-resistant. Based on the resistant pattern of K. pneumoniae, the aminoglycoside-modifying enzymes produced by the organisms were inferred. Among them 90% of 119 strains produced aminoglycosides-modifying enzymes AAC (3)-V, 8% (10/119) AAC (3)-V together with AAC (6')-Ib, AAC (6')-V or ANT (2"). The resistance of two strains was assumed to be permeability change. Besides, 58% (161/280) were sensitive strains without producing any aminoglycoside-modifying enzymes. Bacteria typing done by phage typing or Klebcin in 27 strains showed that most strains were from different origins with few exceptions. The results show the significance for controlling the nosocomial infections and reasonable use of antibiotics.
336株肺炎克雷伯菌中，94%对氨苄西林耐药，而对头孢噻肟和头孢他啶的耐药率低于10%。在所有测试的氨基糖苷类药物中，阿米卡星对肺炎克雷伯菌的活性最强。医院菌株的耐药率高于社区菌株。药敏试验结果显示，42%（119/280）的肺炎克雷伯菌菌株对庆大霉素耐药。根据肺炎克雷伯菌的耐药模式，推断该菌产生的氨基糖苷类修饰酶。其中，119株中有90%产生氨基糖苷类修饰酶AAC(3)-V，8%（10/119）同时产生AAC(3)-V和AAC(6')-Ib、AAC(6')-V或ANT(2")。两株菌的耐药被认为是通透性改变。此外，58%（161/280）为敏感菌株，不产生任何氨基糖苷类修饰酶。对27株菌进行噬菌体分型或克雷伯菌素分型，结果显示大多数菌株来源不同，仅有少数例外。结果表明控制医院感染和合理使用抗生素具有重要意义。
