某醫學中心醫療照護相關感染ESBL-producing Klebsiella pneumoniae菌株之分子流行病學分析

Eextended-spectrum β-lactamases (ESBLs) was first found in 1980's, and they spread to worldwide very soon. ESBLs generally distributed in Enterobacteriaceae such as Escherichia coli and Klebsiella pneumoniae, contributed to the resistance of cephalosporins and aztreonam. From publications in the English literature, ESBLs spreaded to different regions or countries via the traveling host. This study was focused on the definition of ESBL-producing K. pneumoniae related healthcare-associated infections, executed the hospital-wide surveillance, data analysis, and assay the bacteria genotype from Jan 2007 to June 2008. Results showed the highest incidence of ESBL-producing K. pneumoniae related healthcare-associated infections was UTI (59.5%). Infection rate in general ward was 78.6% as higher as 6~7 folds than intensive care unit 11.4%. From antibiotic susceptibility test, sensitive of imipenem and ertapenem for ESBL-producing K. pneumoniae were 100% and 94.6% respectively and resistance to other antibiotics were over 60%. Result of pulse-field gel electrophoresis showed there was not outbreak or existence of dominant strain during the surveillance. Our study demonstrated that carbapenem was still the best choice for treatment of ESBL-producing K. pneumoniae infections.