CAJ | 학술논문

目的：探讨头孢曲松和亚胺培南对脓毒症大鼠肠道各种菌类数量以及细菌耐药性的影响。方法从48只健康SD大鼠中随机抽取8只为正常对照组，其余40只按照15 mg/kg腹腔注射内毒素的方式建立内毒素脓毒症模型；根据建模后24 h是否应用抗生素以及抗生素应用时限再将40只内毒素脓毒症模型鼠细分为脓毒症未治疗组、脓毒症头孢曲松3 d组、脓毒症头孢曲松7 d组、脓毒症亚胺培南3d组和脓毒症亚胺培南7d组（n＝8）。在用头孢曲松和亚胺培南腹腔注射治疗期间，在给药第3d和第7d后分别取大肠内容物进行肠道杆菌、肠球菌和真菌的定量培养和细菌的菌种鉴定。结果用抗生素治疗后，2组大鼠肠道优势菌大肠杆菌和粪肠球菌数量均显著减少（P＜0.05），头孢曲松选择出铜绿假单胞菌和阴沟杆菌，亚胺培南选择出肺炎克雷伯杆菌、变形杆菌和屎肠球菌等条件致病菌，均表现出耐药倾向。结论头孢曲松和亚胺培南抗生素可引起原籍菌群数锐减，铜绿假单胞菌和屎肠球菌等条件致病菌成为优势菌群，引发肠道微生态环境紊乱。
목적：탐토두포곡송화아알배남대농독증대서장도각충균류수량이급세균내약성적영향。방법종48지건강SD대서중수궤추취8지위정상대조조，기여40지안조15 mg/kg복강주사내독소적방식건립내독소농독증모형；근거건모후24 h시부응용항생소이급항생소응용시한재장40지내독소농독증모형서세분위농독증미치료조、농독증두포곡송3 d조、농독증두포곡송7 d조、농독증아알배남3d조화농독증아알배남7d조（n＝8）。재용두포곡송화아알배남복강주사치료기간，재급약제3d화제7d후분별취대장내용물진행장도간균、장구균화진균적정량배양화세균적균충감정。결과용항생소치료후，2조대서장도우세균대장간균화분장구균수량균현저감소（P＜0.05），두포곡송선택출동록가단포균화음구간균，아알배남선택출폐염극뢰백간균、변형간균화시장구균등조건치병균，균표현출내약경향。결론두포곡송화아알배남항생소가인기원적균군수예감，동록가단포균화시장구균등조건치병균성위우세균군，인발장도미생태배경문란。
Objective To study the influence of ceftriaxone and imipenem to sepsis in the rat intestinal flora and bacterial drug resistance.Methods 8 rats were randomly included in normal control group from 48 healthy SD,and the rest of them were built the endotoxin sepsis model using 15 mg/kg intraperitoneal injection of endotoxin.According to whether to apply antibiotics and application deadlines in 24 h after modeling,40 rats were randomly subdivided into sepsis without treatment group,sepsis ceftriaxone 3 d group,sepsis ceftriaxone 7 d group,sepsis imipenem 3 d group and sepsis imipenem 7 d group(n=8).During ceftriaxone and imipenem injection treatment,in the corresponding time,colon contents were taken for enterobacteriaceae,enterococcus strains of quantitative culture and bacteria and fungi identification. Results After treatment with antibiotics,the number of rat intestinal bacteria decreased significantly(P<0.05).Ceftriaxone selected pseudomonas aeruginosa and enterobacter cloacae,while imipenem selected klebsiella pneumoniae, proteus and excrement enterococcus conditional pathogenic bacteria.All showed the inclination resistance. Conclusion Ceftriaxone and imipenem antibiotics could decrease the original bacteria number,so pseudomonas aeruginosa and excrement enterococcus conditional pathogenic bacteria could become advantage bacterium group,causing intestinal micro ecological environment disruption.