CAJ | 학술논문

目的：了解临床分离脑膜败血伊丽莎白菌（ EME）的耐药率并进行耐药表型分析。方法采用微量肉汤稀释法（ MIC）和KB法检测30株EME对22种抗菌药物的耐药率，用纸片法、改良三维试验法进行超广谱β－内酰胺酶（ESBLs）、头孢菌素酶（Ampc）和金属β－内酰胺酶（MBL）的表型确证试验。结果30株EME对所有β－内酰胺类药物的耐药率达70％以上，而对环丙沙星和左氧氟沙星及含酶抑制剂的哌拉西林／他唑巴坦和头孢哌酮／舒巴坦有较好的敏感性。对万古霉素和利福平耐药率分别为23．3％和16．7％。所有菌株均检出ESBLs而未检出Ampc，18株（60．0％）细菌检出产MBL。结论 EME是多药耐药的细菌，产ES－BLs和MBL，其中ESBLs对β－内酰胺类药物的耐药起主要作用。临床常用于治疗革兰阴性杆菌的亚胺培南和美罗培南对EME效果差，而用于治疗革兰阳性球菌的万古霉素和利福平对该菌有治疗活性，复方新诺明、米诺环素、含酶抑制剂类、氟喹喏酮类药物是治疗的首选。
목적：료해림상분리뇌막패혈이려사백균（ EME）적내약솔병진행내약표형분석。방법채용미량육탕희석법（ MIC）화KB법검측30주EME대22충항균약물적내약솔，용지편법、개량삼유시험법진행초엄보β－내선알매（ESBLs）、두포균소매（Ampc）화금속β－내선알매（MBL）적표형학증시험。결과30주EME대소유β－내선알류약물적내약솔체70％이상，이대배병사성화좌양불사성급함매억제제적고랍서림／타서파탄화두포고동／서파탄유교호적민감성。대만고매소화리복평내약솔분별위23．3％화16．7％。소유균주균검출ESBLs이미검출Ampc，18주（60．0％）세균검출산MBL。결론 EME시다약내약적세균，산ES－BLs화MBL，기중ESBLs대β－내선알류약물적내약기주요작용。림상상용우치료혁란음성간균적아알배남화미라배남대EME효과차，이용우치료혁란양성구균적만고매소화리복평대해균유치료활성，복방신낙명、미낙배소、함매억제제류、불규야동류약물시치료적수선。
Objective To investigate drug resistance and resistance phenotypes of Elizabethkingia meningo-septica(EME).Methods The drug resistance rates of 30 strains to 22 antibiotics were detected by MIC and disk dilu-tion method.Phenotypes of extended spectrum β-lactamase(ESBLs), Ampc and metallo β-lactamase(MBL) were de-tected by disk diffusion and modified three dimension test .Results The drug resistance rates of 30 strains toβ-lactam grop drugs were above 70%, all strains were more susceptible to trimethoprim-sulfa(SXT), ciprofloxacin, levofloxacin, piperacillin/tazobactam, cefoperazone/sulbactam.The drug resistance rates to vancomycin and rifampi were 23.3%and 16.7%respectively.All the isolates were detected to have ESBLs but no Ampc , 18 strains(60.0%) had MBL.Con-clusion EME was multi-drug resistance , it can produce ESBLs and MBL .While ESBLs was most responsible for the resistance to β-lactam group drugs .EME was more resistance to imipenem and meropenem which were used to cure most of the gram negative bacilli , but more susceptible to vancomycin and rifampin which were used to cure most of the gram positive coccus.SXT, minocycline,β-lactamase inhibitor and quinolones drugs may be the best choice for its in-fection.