CAJ | 학술논문

目的：探讨三甲中医医院耐碳青霉烯类药物的细菌的种类分布及耐药性情况。方法回顾性分析从临床分类筛选出的74株耐碳青霉烯类药物的抗菌药物的细菌，着重分析其分布种类及耐药特点。结果脑病病区耐碳青霉烯类药物的细菌检出率最高，耐药细菌种类以铜绿假单胞菌为主。30株铜绿假单胞菌对10种抗菌药物的耐药率较低的为妥布霉素（20．0％）、阿米卡星（13．3％）；26株耐碳青霉烯鲍曼不动杆菌均为泛耐药株，耐药率较低的为米诺环素（69．2％）、头孢哌酮／舒巴坦（55．6％）；18株耐碳青霉烯肠杆菌科细菌均为泛耐药株，耐药率较低的为米诺环素（44．4％）、四环素（55．6％）。结论耐碳青霉烯铜绿假单胞菌对氨基糖苷类抗菌药物较为敏感，但临床使用时要注意观察耐药性的变化；耐碳青霉烯鲍曼不动杆菌治疗建议临床上采用头孢哌酮／舒巴坦与米诺环素联合用药；对碳青霉烯类耐药的肠杆菌科细菌体外对四环素类药物有效，然而其体内效果如何还有待进一步证实。耐碳青霉烯类药物的细菌的发生率越来越高，各医院应结合药敏结果，合理用药，以减轻菌株耐药性的发生速度。
목적：탐토삼갑중의의원내탄청매희류약물적세균적충류분포급내약성정황。방법회고성분석종림상분류사선출적74주내탄청매희류약물적항균약물적세균，착중분석기분포충류급내약특점。결과뇌병병구내탄청매희류약물적세균검출솔최고，내약세균충류이동록가단포균위주。30주동록가단포균대10충항균약물적내약솔교저적위타포매소（20．0％）、아미잡성（13．3％）；26주내탄청매희포만불동간균균위범내약주，내약솔교저적위미낙배소（69．2％）、두포고동／서파탄（55．6％）；18주내탄청매희장간균과세균균위범내약주，내약솔교저적위미낙배소（44．4％）、사배소（55．6％）。결론내탄청매희동록가단포균대안기당감류항균약물교위민감，단림상사용시요주의관찰내약성적변화；내탄청매희포만불동간균치료건의림상상채용두포고동／서파탄여미낙배소연합용약；대탄청매희류내약적장간균과세균체외대사배소류약물유효，연이기체내효과여하환유대진일보증실。내탄청매희류약물적세균적발생솔월래월고，각의원응결합약민결과，합리용약，이감경균주내약성적발생속도。
Objective To discuss the species and drug‐resistance of carbapenem‐resistance bacteria in Affilia‐ted Second People′s Hospital of Fujian University of Traditional Chinese Medicine .Methods A total of 74 strains of carbapenem‐resistance bacteria were analyzed retrospectively for the characteristics of species and drug resistance .Re‐sults The highest detection rate was in encephalopathy ward and the main drug‐resistant bacteria was Pseudomonas aeruginosa .The lower drug‐resistance of 30 strains Pseudomonas aeruginosa to ten kinds of antimicrobial were To‐bramycin (20 .0% ) ,Amikacin (13 .3% ) .The 26 strains carbapenem‐resistance Acinetobacter baumannii were all pan resistant bacteria ,the lower drug‐resistance of these bacteria to antibacterial gents were Minocycline (69 .2% ) ,Cef‐operazone/Shu ba temple (55 .6% ) .The 18 strains of carbapenem‐resistance Enterobacteriaceae bacteria were all pan resistant bacteria ,the lower drug resistance of these bacteria were Minocycline (44 .4% ) ,Tetracycline (55 .6% ) . Conclusion Carbapenem‐resistance Pseudomonas aeruginosa is sensitive to aminoglycoside antibiotic‐drugs ,but it needs to pay attention to the changes of drug resistance in clinic .Carbapenem‐resistance Acinetobacter baumannii should be treated by Cefoperazone/Shu ba temple and Minocycline in clinic .Carbapenem‐resistance Enterobacteriace‐ae bacteria might treated effectively by tetracycline drug in vitro ,but in vivo it remains to be further confirmed .