CAJ | 학술논문

目的：比较产超广谱β-内酰胺酶（ ESBL）肺炎克雷伯菌的表型鉴定方法，以及分析我院ESBLs肺炎克雷伯菌在各种临床标本的分布，初步筛选多重耐药菌，做出药物敏感性检测结果，为预防和控制多重耐药菌在医院内传播，提前给临床提供治疗依据。方法用双纸片协同试验和CLSI认证试验法检测产ESBLs肺炎克雷伯菌，比较两种方法的检出率。结果119株产ESBLs肺炎克雷伯菌在临床各种标本中被分离，其中痰标本最多，为76株，其他来源于分泌物标本16株和尿标本11株，脓标本为8株，血和胸腹水标本均为4株。这些病人在进行各种临床治疗措施中，静脉导管115例（96.6%）、留置导尿管的27例（22.7%）、气管插管10例（8.4%）、医疗器材穿刺9例（7.5%）等。用双纸片协同试验和CLSI认证试验确定的ESBLs的菌株分别为112株（94.1%）和118株（99.2%）。结论当没有分子生物学相关设备时，使用CLSI认证试验是非常有效的早期检测ESBLs肺炎克雷伯菌的方法。
목적：비교산초엄보β-내선알매（ ESBL）폐염극뢰백균적표형감정방법，이급분석아원ESBLs폐염극뢰백균재각충림상표본적분포，초보사선다중내약균，주출약물민감성검측결과，위예방화공제다중내약균재의원내전파，제전급림상제공치료의거。방법용쌍지편협동시험화CLSI인증시험법검측산ESBLs폐염극뢰백균，비교량충방법적검출솔。결과119주산ESBLs폐염극뢰백균재림상각충표본중피분리，기중담표본최다，위76주，기타래원우분비물표본16주화뇨표본11주，농표본위8주，혈화흉복수표본균위4주。저사병인재진행각충림상치료조시중，정맥도관115례（96.6%）、류치도뇨관적27례（22.7%）、기관삽관10례（8.4%）、의료기재천자9례（7.5%）등。용쌍지편협동시험화CLSI인증시험학정적ESBLs적균주분별위112주（94.1%）화118주（99.2%）。결론당몰유분자생물학상관설비시，사용CLSI인증시험시비상유효적조기검측ESBLs폐염극뢰백균적방법。
Objective:To compare the phenotype identifying methods of extended-spectrum β-lactamase producing K. pneumoniae ,observe the distribution of ESBLs K. pneumoniae from various clinical specimens,select the Multi-drug re-sistance( MDR),get the result of drug sensitive test,prevent and control the propagation of MDR in the hospital,and pro-vide the basis for clinical treatment. Methods:The detection rates of Double-disc synergy test( DDST)and the CLSI con-firmatory test were compared. Results:A total of 119 ESBLs-producing Klebsiella pneumoniae was isolated in a variety of clinical specimens,76 of which were collected from sputum,16 from secretions,11 from urine,8 from pus,4 from blood and 4 from pleural and peritoneal effusions. These patients underwent a variety of clinical treatments,the catheter in 115 cases(96. 6%),indwelling catheter in 27 cases(22. 7%),endotracheal intubation in 10 cases(8. 4%),medical equip-ment and puncture in 9 cases(7. 5% )and the like. The detection rate of DDST was 94. 1%(112 samples),and the de-tection rate of CLSI confirmatory test was 99. 2%(118samples). Conclusion The results shows that using CLSI confirma-tory test is a very effective method in the early stage without facilities for molecular characterization.