CAJ | 학술논문

目的：了解产超广谱β-内酰胺酶（ESBLs）的革兰阴性杆菌酶对抗菌药物的耐药性，为临床合理使用抗生素提供依据，提高疗效。方法用VITEK32全自动细菌鉴定仪对细菌进行鉴定和纸片扩散法（K-B法）进行药敏检测。结果从分离的317株革兰阴性杆菌中，产ESBLs菌以大肠埃希菌和肺炎克雷伯菌为主，通过药敏实验显示，产ESBLs菌对15种抗菌药物的耐药率均明显高于非产ESBLs株。结论随着抗菌药物的广泛应用，产ESBLs菌株对青霉素类、头孢菌素类和单环类抗生素的耐药率极高；具有多重耐药性，对加酶抑制剂复合抗菌药物和碳青酶烯类敏感率高，临床要重视ESBLs的检测，治疗时应根据药敏试验结果选择抗生素，指导临床合理用药。产ESBLs菌的阴性杆菌对头孢三代，氨曲南，氨基糖苷类，喹诺酮类呈不同程度耐药。对加酶抑制剂复合抗菌药物和碳青酶烯类敏感率高，临床可根据药敏试验结果合理使用抗生素。
목적：료해산초엄보β-내선알매（ESBLs）적혁란음성간균매대항균약물적내약성，위림상합리사용항생소제공의거，제고료효。방법용VITEK32전자동세균감정의대세균진행감정화지편확산법（K-B법）진행약민검측。결과종분리적317주혁란음성간균중，산ESBLs균이대장애희균화폐염극뢰백균위주，통과약민실험현시，산ESBLs균대15충항균약물적내약솔균명현고우비산ESBLs주。결론수착항균약물적엄범응용，산ESBLs균주대청매소류、두포균소류화단배류항생소적내약솔겁고；구유다중내약성，대가매억제제복합항균약물화탄청매희류민감솔고，림상요중시ESBLs적검측，치료시응근거약민시험결과선택항생소，지도림상합리용약。산ESBLs균적음성간균대두포삼대，안곡남，안기당감류，규낙동류정불동정도내약。대가매억제제복합항균약물화탄청매희류민감솔고，림상가근거약민시험결과합리사용항생소。
Objective To evaluate the extended-spectrum beta-lactamases (ESBLs) producing clinical isolates of gram negative bacil i and their antibiotic resistance and to provide suggestions on empirical treatment against the bacteria. Methods examined for the production of ESBLs by Vitek-32 and antibacterial susceptibility was tested by Kindy Bauer method. Results:Among a total of 317 Gram negative isolates,There were most of escherichia coli (E.coli)and klebsiel a pneumoniae (K.pneumoniae) producing ESBLs. To examined for the production of ESBLs and antibacterial susceptibility test,the drug resistance rate of ESBLs producing strains was much higher than that of strains no producing ESBLs to 15 types antibiotics. Conclusions:Along with antibiotics widespread application,The resistance rate of the ESBLs-producing strains to penicil ins、cephalosporins and monocyclic beta-lactam antibiotics were very high.The ESBLs-producing strains were multidrug resistant,but both of them were stil highly sensitive to carbopenems and these β-lactamase inhibitor combmations.Now,Drug resistance became more and more serious,which suggested clinical treatment should choose the antibiotics according to susceptiblity tests and detection for ESBLs producing strains and provide the reference for the clinical antibiotics usage.