CAJ | 학술논문

目的：筛查肠杆菌科细菌产碳青霉烯酶的情况，了解产碳青霉烯酶的细菌分布情况。方法收集中山大学附属第一医院2008年5月至2010年4月临床分离的27株[厄他培南最低抑菌浓度（MIC）≥2μg/mL]肠杆菌科细菌。用微量肉汤稀释法测定亚胺培南、美罗培南、厄他培南对细菌的MIC，改良Hodge试验作为表型确证试验。结果27株厄他培南耐药菌株中，包括15株阴沟肠杆菌、7株大肠埃希菌、2株肺炎克雷伯菌、2株弗氏柠檬酸杆菌和1株产酸克雷伯菌。经改良Hodge试验检测出3株阳性菌株，分别为2株阴沟肠杆菌和1株产酸克雷伯菌。Hodge试验阳性菌株对美罗培南全部耐药，对亚胺培南2株耐药，1株中介。结论改良Hodge试验可以快速筛查肠杆菌科细菌产碳青霉烯酶的情况，敏感性高、操作简单，可在临床实验室中常规开展。
목적：사사장간균과세균산탄청매희매적정황，료해산탄청매희매적세균분포정황。방법수집중산대학부속제일의원2008년5월지2010년4월림상분리적27주[액타배남최저억균농도（MIC）≥2μg/mL]장간균과세균。용미량육탕희석법측정아알배남、미라배남、액타배남대세균적MIC，개량Hodge시험작위표형학증시험。결과27주액타배남내약균주중，포괄15주음구장간균、7주대장애희균、2주폐염극뢰백균、2주불씨저몽산간균화1주산산극뢰백균。경개량Hodge시험검측출3주양성균주，분별위2주음구장간균화1주산산극뢰백균。Hodge시험양성균주대미라배남전부내약，대아알배남2주내약，1주중개。결론개량Hodge시험가이쾌속사사장간균과세균산탄청매희매적정황，민감성고、조작간단，가재림상실험실중상규개전。
Objective To screen out the carbapenemase-producing Enterobacter in the first affiliated hospital of Sun Yat-Sen uni-versity and investigate the clinical distribution in order to select antibiotics correctly according the results .Methods 27 Enterobact-er isolated with ertapenem MIC ≥2 μg/mL were randomly collected from May 2008 to April 2010 in the first affiliated hospital of Sun Yat-Sen university .The MIC of imipenem ,meropenem and ertapenem were determined by broth dilution assay .Modified Hodge test was used to screen out carbapenemase-producing Enterobacter as the phenoypic confirmatory test .Results Among 27 ertapen-em resistant Enterobacter ,there were 15 Enterobacter cloacae strains ,7 Escherichia coli strais ,2 K lebsiella pneumoniao strains ,2 Citrobacter f reundii and 1 Klebsiellaoxytoca strain .There were 3 modified Hodge test positive bacterial strains including 2 Enter-obactor cloacae ,and 1 K lebsiella oxytoca .They were all resistant to meropenem ,while 2 of the three modified Hodge test positive bacterial strains were resistant to imipenem ,and one was intermediate .Conclusion It′s convenience to screen out the carbapene-mase-producing Enterobacter by the modified Hodge test with a high sensitivity .It is suggested that M HT should be widely used in clinical Laboratory .