CAJ | 학술논문

目的：了解磷霉素氨丁三醇对尿标本中肠杆菌科细菌的体外抗菌活性，指导临床合理用药。方法采用 ATB 系统对中段尿标本分离的1185株肠杆菌科细菌进行鉴定，纸片扩散法进行药敏试验和 ESBLs 的检测，结果按 CLSI 2012年版标准判断；应用 WHONET 5．6软件分析病原菌的分布及耐药情况。结果1185株肠杆菌科细菌对磷霉素氨丁三醇的敏感率为90．8％，其中大肠埃希菌929株（78．4％）、肺炎克雷伯菌124株（10．5％）和奇异变形杆菌69株（5．8％）对磷霉素氨丁三醇的敏感率分别为93．1％、88．7％和79．7％。住院患者尿标本分离的肠杆菌科细菌对磷霉素氨丁三醇的敏感率低于门诊患者（87．0％对92．7％）。大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌 ESBLs 的检出率分别为54．4％、38．7％和23．2％。产ESBLs的大肠埃希菌和肺炎克雷伯菌对磷霉素氨丁三醇的敏感率分别为89．5％和87．5％。结论尿标本培养获得的肠杆菌科细菌以大肠埃希菌为主，磷霉素氨丁三醇对尿标本分离的产 ESBLs 的大肠埃希菌和肺炎克雷伯菌的肠杆细菌科细菌具有良好的体外抗菌活性，可作为临床经验用药之一。
목적：료해린매소안정삼순대뇨표본중장간균과세균적체외항균활성，지도림상합리용약。방법채용 ATB 계통대중단뇨표본분리적1185주장간균과세균진행감정，지편확산법진행약민시험화 ESBLs 적검측，결과안 CLSI 2012년판표준판단；응용 WHONET 5．6연건분석병원균적분포급내약정황。결과1185주장간균과세균대린매소안정삼순적민감솔위90．8％，기중대장애희균929주（78．4％）、폐염극뢰백균124주（10．5％）화기이변형간균69주（5．8％）대린매소안정삼순적민감솔분별위93．1％、88．7％화79．7％。주원환자뇨표본분리적장간균과세균대린매소안정삼순적민감솔저우문진환자（87．0％대92．7％）。대장애희균、폐염극뢰백균화기이변형간균 ESBLs 적검출솔분별위54．4％、38．7％화23．2％。산ESBLs적대장애희균화폐염극뢰백균대린매소안정삼순적민감솔분별위89．5％화87．5％。결론뇨표본배양획득적장간균과세균이대장애희균위주，린매소안정삼순대뇨표본분리적산 ESBLs 적대장애희균화폐염극뢰백균적장간세균과세균구유량호적체외항균활성，가작위림상경험용약지일。
Objective To explore the in vitro activities of antimicrobial agents including fosfomycin tromethamine against Enter-obacteriaceae isolates from urine samples and provide evidence for reasonable use of antibiotics.Methods A total of 1 185 Enter-obacteriaceae isolates from midstream urine samples were identified by ATB system.Antimicrobial susceptibility and ESBLs production were tested by Kirby-Bauer method.The results were analyzed according to the breakpoints of CLSI 2012.WHO-NET 5.6 software was used to retrospectively analyze the distribution and antibiotic susceptibility of pathogenic bacteria.Re-sults Overall,about 90.8% of the 1 185 isolates tested were susceptible to fosfomycin tromethamine.The top three species of bacteria showing the highest suceptibility rate to fosfomycin tromethamine were Escherichia coli (93.1%),Klebsiella pneu-moniae (88.7%),and Proteus spp.(79.7%).The Enterobacteriaceae isolates from urine samples of inpatients were less sus-ceptibe to the antimicrobial agents tested compared to the isolates from outpatients (87.0% versus 92.7% susceptible).ESBLs were identified in 54.4% of Escherichia coli ,38.7% of Klebsiella pneumoniae and 23.2% of Proteus strains.The ESBL-pro-ducing E.coli (89.5%)and K.pneumoniae (87.5%)were highly susceptible to fosfomycin tromethamine.Conclusions Esch-erichia coli is the most popular Enterobacteriaceae isolated from urine samples.Fosfomycin tromethamine has good in vitro an-tibacterial activity against Enterobacteriaceae strains,including ESBLs-producing E.coli and K.pneumoniae.Fosfomycin tromethamine is a valuable therapeutic option for urinary tract infections.