CAJ | 학술논문

目的：了解该院大肠杆菌产超广谱β-内酰胺酶（ESBLs）的现状并分析其耐药性，以指导临床合理使用抗菌药物。方法采用K-B法对临床分离的87株大肠杆菌进行药敏试验，并回顾性分析其在临床的分布情况，使用WHONET 5．4分析菌株药敏情况。结果87株大肠杆菌检出41株产ESBLs ，占47．26％（41/87）；标本主要来自尿液、伤口分泌物（包括恶露）、痰液、血液；药敏试验显示，亚胺培南、美罗培南的敏感率为100％，哌拉西林/他唑巴坦敏感率为90．25％，阿米卡星敏感率为82．93％，呋喃妥因敏感率为73．16％，其他药物的敏感率均小于50．00％。结论该院大肠杆菌产ESBLs的阳性率处于较高水平，对亚胺培南、美罗培南以外的16种药物均存在不同程度的耐药性，医院要加强抗菌药物的分级使用管理，临床医师应结合菌株的药敏试验选择最佳的抗菌药物，以减少医院感染的发生。
목적：료해해원대장간균산초엄보β-내선알매（ESBLs）적현상병분석기내약성，이지도림상합리사용항균약물。방법채용K-B법대림상분리적87주대장간균진행약민시험，병회고성분석기재림상적분포정황，사용WHONET 5．4분석균주약민정황。결과87주대장간균검출41주산ESBLs ，점47．26％（41/87）；표본주요래자뇨액、상구분비물（포괄악로）、담액、혈액；약민시험현시，아알배남、미라배남적민감솔위100％，고랍서림/타서파탄민감솔위90．25％，아미잡성민감솔위82．93％，부남타인민감솔위73．16％，기타약물적민감솔균소우50．00％。결론해원대장간균산ESBLs적양성솔처우교고수평，대아알배남、미라배남이외적16충약물균존재불동정도적내약성，의원요가강항균약물적분급사용관리，림상의사응결합균주적약민시험선택최가적항균약물，이감소의원감염적발생。
Objective To understand status of the ultra broad spectrum beta lactamase (ESBLs) of MCH ,and analyze its drug resistance ,and to provide guidance to clinical for reasonable use antibiotics .Methods By the method of K-B ,87 strains of e .coli were tested for their their clinical distribution and drug sensitive .Strains of antibiotic sus-ceptibility was analyzed by WHONET5 .4 .Results 41 strains of producing extended-spectrumβ-lactamases were de-tected in the 87 strains of e .coli ,47 .26% (41/87);specimens mainly come from urine ,wound secretion(including lo-chia) ,sputum and blood ;Susceptibility testing shows sensitive rate of imipenem and meropenem were 100% ,Pip-eracillin /tazobactam was 90 .25% ,amikacin was 82 .93% ,Nitrofurantoin was 73 .16% ,others are less than 50% . Conclusion Positive rate of beta lactamase (ESBLs) from the ultra broad spectrum of MCH is in a relatively high level ,it has different drug resistance to 16 kinds of drug except imipenem and meropenem ,the use and classification management of antimicrobial drugs should be Strengthened in hospital .In order to reduce the incidence of nosocomial infection .Clinicians should combine with strain susceptibility testing to choose the most suitable antimicrobial .