CAJ | 학술논문

目的：了解儿童泌尿系感染分离大肠埃希菌中产 ESBLs 菌株的发生率和产 ESBLs 菌株和非产 ES-BLs 的耐药性。方法儿童泌尿系感染分离的产 ESBLs 大肠埃希菌48株，通过 CLSI 表型确证试验（纸片增强法）检测产 ESBLs 菌株，琼脂稀释法进行药敏试验。结果48株儿童泌尿系感染分离的大肠埃希菌中，产 ESBLs 菌株的发生率为45.8%（22/48），其中复杂性尿路感染产 ESBLs 菌株高达66.7%（12/18）。产 ESBLs 菌株对氨苄西林，第一、二代头孢菌素，头孢噻肟耐药显著；对头孢他啶、头孢吡肟和阿莫西林/克拉维酸耐药率超过30%；对头孢哌酮/舒巴坦、头孢美唑、阿米卡星耐药率在30%以下；对美罗培南耐药率为0。非产 ESBLs 菌株对氨苄西林，第一、二代头孢菌素类耐药率较高，对其他抗菌药物均较为敏感。产 ESBLs 菌株对第一、二代头孢菌素，头孢噻肟，头孢他啶，头孢吡肟耐药率显著高于非产 ESBLs 菌株（P <0.05）。结论儿童泌尿系感染分离大肠埃希菌中产 ESBLs菌株的发生率较高，产 ESBLs 菌株多重耐药显著，临床应加强检测和监测。
목적：료해인동비뇨계감염분리대장애희균중산 ESBLs 균주적발생솔화산 ESBLs 균주화비산 ES-BLs 적내약성。방법인동비뇨계감염분리적산 ESBLs 대장애희균48주，통과 CLSI 표형학증시험（지편증강법）검측산 ESBLs 균주，경지희석법진행약민시험。결과48주인동비뇨계감염분리적대장애희균중，산 ESBLs 균주적발생솔위45.8%（22/48），기중복잡성뇨로감염산 ESBLs 균주고체66.7%（12/18）。산 ESBLs 균주대안변서림，제일、이대두포균소，두포새우내약현저；대두포타정、두포필우화아막서림/극랍유산내약솔초과30%；대두포고동/서파탄、두포미서、아미잡성내약솔재30%이하；대미라배남내약솔위0。비산 ESBLs 균주대안변서림，제일、이대두포균소류내약솔교고，대기타항균약물균교위민감。산 ESBLs 균주대제일、이대두포균소，두포새우，두포타정，두포필우내약솔현저고우비산 ESBLs 균주（P <0.05）。결론인동비뇨계감염분리대장애희균중산 ESBLs균주적발생솔교고，산 ESBLs 균주다중내약현저，림상응가강검측화감측。
Objective To investigate the prevalence of extended-spectrum -lactamases(ESBLs)and the antibiotic resistance in uropathogeni escherichia coli in children. Methods A total of 48 uropathogenic escherichia coli strains isola-ted,ESBLs-producers were detected by CLSI phenotypic confirmatory test and susceptibilities were tested by agar dilution method. Results 45. 8% of isolates were ESBLs producers in those isolates,and ESBLs-producers account for 66. 7%strains in the complicated urinary tract infection. ESBLs producers were highly resistant to ampicillin,cefazolin,cefuroxime and cefotaxime. The resistant rate of ceftazidime,cefepime,amoxicillin-clavulanic acid was more than 30% ,cefoperazone-sulbactam,cefmetazole and aimikacin was less than 30% ,none was resistant to meropenem in ESBLs producers. The re-sistant rate of ampicillin,cefazolin,cefuroxime was more than 40% and most were susceptible to other antimicrobial agents in non ESBLs producers. The resistant rate of cefazolin,cefuroxime,cefotaxime,ceftazidime and cefepime was significantly higher in ESBLs producers than that in non ESBLs producers. Conclusions With resistance to most of antimicrobial a-gents,ESBLs-producers are highly prevalent in uropathogeni escherichia coli isolates in children,so more attention should be paid to survey and detect those strains.