CAJ | 학술논문

　　目的了解NICU感染产超广谱β-内酰胺酶（ESBLs）大肠埃希菌与肺炎克雷伯菌耐药发生情况，以更好的选择抗菌药物提供依据。方法细菌鉴定和药敏试验用ATB Expression细菌鉴定仪及其配套试剂进行自动分析。结果2010～2012年全院共培养和分离出大肠埃希菌3043株与肺炎克雷伯菌2226株。NICU大肠埃希菌374株（12.29%）中产ESBLs145株（38.77%）和肺炎克雷伯菌799株（34.41%）产ESBLs 384株（48.06%）。产ESBLs菌对青霉素类、头孢菌素和氨曲南均产生耐药，第四代头孢头孢吡肟耐药率也达60%以上，对亚胺培南或美洛培南、丁胺卡那耐药低，其次为派拉西林/他唑巴坦和头孢西丁。而头孢西丁在产ESBLs肺炎克雷伯菌耐药率已上升至50%。结论新生儿为一特殊群体在临床用药相对较为狭窄，在实验室开展ESBLs的检测，对指导临床合理使用抗菌药物、延缓细菌耐药性的产生、有效控制产ESBLs菌的院内播散具有十分重要的意义。
　　목적료해NICU감염산초엄보β-내선알매（ESBLs）대장애희균여폐염극뢰백균내약발생정황，이경호적선택항균약물제공의거。방법세균감정화약민시험용ATB Expression세균감정의급기배투시제진행자동분석。결과2010～2012년전원공배양화분리출대장애희균3043주여폐염극뢰백균2226주。NICU대장애희균374주（12.29%）중산ESBLs145주（38.77%）화폐염극뢰백균799주（34.41%）산ESBLs 384주（48.06%）。산ESBLs균대청매소류、두포균소화안곡남균산생내약，제사대두포두포필우내약솔야체60%이상，대아알배남혹미락배남、정알잡나내약저，기차위파랍서림/타서파탄화두포서정。이두포서정재산ESBLs폐염극뢰백균내약솔이상승지50%。결론신생인위일특수군체재림상용약상대교위협착，재실험실개전ESBLs적검측，대지도림상합리사용항균약물、연완세균내약성적산생、유효공제산ESBLs균적원내파산구유십분중요적의의。
Objectve To investigate the drug resistance of extended-spectrumβ-lactamases(ESBLs) producing Escherichia coli and Klebsiella pneumoniae in NICU,Provding edidence for the clinical rational administration of antimicrobial drugs. Methods The identification of bacteria and antibiotic susceptibility were performed by Microscan ATB Exprssion Analyzer. Results Among 374 isolates of Escherichia coli in NICU, 145 strains(38.77%)were isolated producing ESBLs.Among 799 isolates of Klebsiella pneumoniae,384 strains(48.06%) were isolated producing ESBLs.ESBLs-producing bacteria showed high resistance to a greate number of antimicrobial drugs,and relatively low resistance to imipenem,amikacin,piperacillin/tazobactam, and cefoxitin.but the Klebsiella pneumoniae 50%resistances to cefoxitin were showed in NICU. Conclusions Detection of ESBLs prodution and susceptibility to antibiotics in time can provide guidance to rational clinical administions of drugs and also prevent the emergence of the drug resistant strains.