Objective To analyze the current drug resistance and risk factors of hospital acquired pneumonia( HAP) due to extended spectrumβ-lactamase ( ESBLs) producing Escherichia coli and Klebsiella pneumoniae, and to estimate the prevalence trend of ESBLs producing strains. Methods FromApril 2007 to January 2008, 140 patients of Xinhua Hospital with HAP due to E. coli and K. pnermoniae were enrolled.Among them, 88 patients were with ESBLs producing strains and 52 patients were with non-ESBLs producing strains. Risk factors were analyzed by comparing between these patients. The rate of drug resistance was determined by antibiotic sensitive test. Fifty-three ESBLs producing strains were genotyped by random amplified polymorphic DNA ( RAPD) . Results The rate of drug resistance of ESBLs producing strains was
higher than that of non-ESBLs producing strains. ICU stay, use of third- and forth-generation cehpalosporin were found to be the independent risk factors by multivariate analysis with logistic regression. By RAPD, 37 ESBLs producing E. coli strains were divided into 27 types and 16 ESBLs producing K. pneumoniae strains were divided into 13 types. Conclusions ICU stay, use of third-generation and forth-generation cehpalosporin remain as major risk factors in the HAP due to ESBLs producing E. coli and K. pneumoniae.RAPD is an economic, quick and credible method for epidemic analysis
Citation：
HUANG Beijie,GUO Xuejun,NI Peihua,LIU Yin,LUO Yanrong.. Risk Factors and Genotyping of Nosocomial Pneumonia Due to Extended Spectrum β-Lactamase Producing EscherichiaColi and KlebsiellaPneumoniae. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(2): 172-176. doi:
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Copyright © the editorial department of Chinese Journal of Respiratory and Critical Care Medicine of West China Medical Publisher. All rights reserved
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洪学仁, 高红梅, 张少军, 等. 重症监护病房医院感染及护理对策. 中国感染控制杂志, 2004, 3: 61-62.
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张祎捷, 赵敏, 陈娜, 等. 外科手术部位与术后肺炎的相关性探讨. 山东医药,2008,48:95.
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- 1. Liu PY, Tung JC, Ke SC, et al.Molecular epidemiology of extendedspectrum beta-lactamase-producing Klebsiella pneumoniae isolates in a district hospital in Taiwan. J Clin Microbiol, 1998, 36: 2759 -2762.
- 2. 中华医学会呼吸病学分会. 医院获得性肺炎诊断和治疗指南( 草案) . 中华结核和呼吸杂志, 1999, 22: 201-203.
- 3. Pitout JD, Nordmann P, Laupland KB, et al. Emergence of Enterobacteriaceae producing extended-spectrum beta-lactamases ( ESBLs) in the community. J Antimicrob Chemother, 2005, 56: 52 -59.
- 4. 俞云松. 超广谱β-内酰胺酶研究进展. 中华医学杂志, 2006 ,86: 641-644 .
- 5. 王培兰, 苏伟, 刘又宁, 等. β-内酰胺类抗菌药物及其复合制剂对医院感染菌株体外抗菌活性研究. 中华医院感染学杂志,2006, 16: 9-11.
- 6. Van Bambeke F, Glupczynski Y, Plésiat P, et al. Antibiotic efflux pumps in prokaryotic cells: occurrence, impact on resistance and strategies for the future of antimicrobial therapy. J Antimicrob Chemother, 2003, 51: 1055-1065.
- 7. Jacoby GA. Extended-spectrum beta-lactamases and other enzymes providing resistance to oxyimino-beta-lactams. Infect Dis Clin North Am, 1997, 11: 875-887.
- 8. 黄瑞娟, 叶临湘, 冯启明. 大肠埃希菌产超广谱β-内酰胺酶的危险因素研究. 疾病控制杂志, 2008 , 12 : 141-143.
- 9. 洪学仁, 高红梅, 张少军, 等. 重症监护病房医院感染及护理对策. 中国感染控制杂志, 2004, 3: 61-62.
- 10. 张祎捷, 赵敏, 陈娜, 等. 外科手术部位与术后肺炎的相关性探讨. 山东医药,2008,48:95.
