CAJ | 학술논문

目的：了解菌血症患儿血培养放射根瘤菌的基因型及药敏情况。方法收集2013年2月—2014年2月某2所医院全部菌血症患儿血培养的放射根瘤菌，应用聚合酶链反应（PCR）扩增其16S rDNA 片段，采用脉冲场凝胶电泳（PFGE）鉴定细菌基因型，以及 K-B 法做药敏试验。结果12例血培养阳性患儿共检出13株放射根瘤菌，包括3种基因型；其16S r DNA 序列与放射根瘤菌 IFM 10623株同源性达99％。依据临床和实验室标准化协会（CLSI）2013铜绿假单胞菌药敏标准，13株菌对头孢他啶、哌拉西林、替卡西林、哌拉西林／他唑巴坦、替卡西林／克拉维酸、氨曲南与多粘菌素 B 耐药；而对头孢吡肟、多尼培南、亚胺培南、美罗培南、妥布霉素、奈替米星、环丙沙星、左氧氟沙星和诺氟沙星敏感。此外，13株菌对头孢噻肟和头孢曲松有较大的抑菌圈。结论临床需根据药敏试验结果，选择药物治疗放射根瘤菌感染；其中头孢噻肟和头孢曲松是治疗患儿放射根瘤菌感染的较好选择。
목적：료해균혈증환인혈배양방사근류균적기인형급약민정황。방법수집2013년2월—2014년2월모2소의원전부균혈증환인혈배양적방사근류균，응용취합매련반응（PCR）확증기16S rDNA 편단，채용맥충장응효전영（PFGE）감정세균기인형，이급 K-B 법주약민시험。결과12례혈배양양성환인공검출13주방사근류균，포괄3충기인형；기16S r DNA 서렬여방사근류균 IFM 10623주동원성체99％。의거림상화실험실표준화협회（CLSI）2013동록가단포균약민표준，13주균대두포타정、고랍서림、체잡서림、고랍서림／타서파탄、체잡서림／극랍유산、안곡남여다점균소 B 내약；이대두포필우、다니배남、아알배남、미라배남、타포매소、내체미성、배병사성、좌양불사성화낙불사성민감。차외，13주균대두포새우화두포곡송유교대적억균권。결론림상수근거약민시험결과，선택약물치료방사근류균감염；기중두포새우화두포곡송시치료환인방사근류균감염적교호선택。
Objective To investigate genotypes and antimicrobial susceptibility of Rhizobium radiobacter (R.radiobact-er)isolated from pediatric patients with bacteremia.Methods R.radiobacter strains from blood cultures of pediatric pa-tients with bacteremia from February 2013 through February 2014 were collected.16S rDNA fragment was amplified by polymerase chain reaction(PCR),bacterial genotypes were identified by pulsed-field gel electrophoresis (PFGE),antimi-crobial susceptibility testing were performed by Kirby-Bauer disk diffusion method.Results 13 isolates of R.radiobacter were isolated from 12 children with positive blood culture,which including 3 genotypes,the homology of 16S rDNA fragment and R.radiobacter IFM 10623 was up to 99%.According to CLSI 2003 standard,these 13 R.radiobacter were resistant to ceftazidime,piperacillin,ticarcillin,piperacillin/tazobactam,ticarcillin/clavulanic acid,aztreo-nam and polymyxin B,but sensitive to cefepime,doripenem,imipenem,meropenem,tobramycin,netilmicin,cip-rofloxacin,levofloxacin,and norfloxacin.In addition,cefotaxime and ceftriaxone showed larger inhibition zone. Conclusion Therapy of R.radiobacter infection should be based on antimicrobial susceptibility testing results;cefo-taxime and ceftriaxone are better selection for the therapy of R.radiobacter infection in pediatric patients.