Analysis of drug resistance of Klebsiella pneumoniae lower respiratory tract infection in patients with coexisting pulmonary tuberculosis and diabetes / 国际检验医学杂志

ABSTRACT

Objective To investigate the drug resistance characteristics of Klebsiella pneumoniae lower respiratory tract infection in the patients with coexisting pulmonary tuberculosis (TB) and diabetes mellitus (DM ) to provide a basis for the prevention and treatment of Klebsiella pneumoniae infections .Methods The lower respiratory tract specimens were collected from the patients with coexisting pulmonary TB and DM in the Shenzhen Hospital of Peking University from January 2009 to May 2015 .The bacteri‐al species was identified by using the France Bio‐Merieux Vitek2‐Compact automatic microorganism identification instrument ,the drug susceptibility tests adopted the disk method (K‐B) ,and extended spectrum β lactamase (ESBLs) detection was conducted ,the drug susceptibility test results were judged according to the CLSI standards .The data were analyzed by the WHONET 5 .6 and SPSS18 .0 software .Results 139 strains of Klebsiella pneumoniae were isolated from the lower respiratory tract specimens in the patients with coexisting pulmonary TB and DM ,the ESBLs producing rate was up to 46 .0% .The drug susceptibility testing results showed that the resistance of non‐ESBLs producing and ESBLs producing Klebsiella pneumoniae to cefoperazone / sulbactam ,pip‐eracillin/tazobactam ,imipenem ,meropenem ,cefotetan and amikacin was lower and less than 15 .0% ,the resistance of ESBLs‐produ‐cing strains to most antibacterial drugs was significantly higher than that of non‐ESBLs producing strains (P< 0 .05) .Conclusion Klebsiella pneumoniae isolated from the patients with coexisting pulmonary TB and DM complicating lower respiratory tract infec ‐tion in this hospital has the high detection rate of ESBLs producing strains and strong drug resistance ,therefore clinic should strengthen the ESBLs detection and drug resistance monitoring for preventing the generation of multi‐drug resistance .In the treat‐ment of its infection ,the first choice is containing enzyme inhibitors and carbapenems antibacterial drugs .