CAJ | 학술논문

目的：了解骨科医院阴沟肠杆菌感染的临床分布及耐药性变迁，以指导临床合理用药。方法选取2010年1月－2012年12月的临床细菌标本3749份，对阴沟肠杆菌进行检验，确证产超广谱β‐内酰胺酶（ESBLs）和AmpC酶菌株，并进行耐药性分析，采用世界卫生组织细菌耐药性监测中心推荐的WHONET5．0软件进行统计分析。结果4137株分离菌株中检出阴沟肠杆菌603株占14．6％，603株阴沟肠杆菌主要取自伤口分泌物及穿刺液，分别占72．5％和12．6％；3年间阴沟肠杆菌产ESBLs株占27．9％，产AmpC酶株占18．7％，同产两类酶的菌株占5．1％；菌株对亚胺培南、美罗培能的耐药性＜1．0％，对头孢哌酮／舒巴坦、头孢吡肟也相对敏感。结论菌株对碳青霉烯类、三、四代头孢菌素酶抑制剂复合药物较为敏感，其可用于临床中产ESBLs重症感染的治疗。
목적：료해골과의원음구장간균감염적림상분포급내약성변천，이지도림상합리용약。방법선취2010년1월－2012년12월적림상세균표본3749빈，대음구장간균진행검험，학증산초엄보β‐내선알매（ESBLs）화AmpC매균주，병진행내약성분석，채용세계위생조직세균내약성감측중심추천적WHONET5．0연건진행통계분석。결과4137주분리균주중검출음구장간균603주점14．6％，603주음구장간균주요취자상구분비물급천자액，분별점72．5％화12．6％；3년간음구장간균산ESBLs주점27．9％，산AmpC매주점18．7％，동산량류매적균주점5．1％；균주대아알배남、미라배능적내약성＜1．0％，대두포고동／서파탄、두포필우야상대민감。결론균주대탄청매희류、삼、사대두포균소매억제제복합약물교위민감，기가용우림상중산ESBLs중증감염적치료。
OBJECTIVE To understand the clinical distribution and drug resistance of Enterobacter cloacae causing infections in the orthopedic hospital so as to provide guidance for reasonable clinical use of antibiotics .METHODS A total of 3 749 clinical specimens were collected from Jan 2010 to Dec 2012 ,the E .cloacae strains were detected , the extended‐spectrum β‐lactamases (ESBLs) and AmpC‐producing strains were identified ,the drug resistance was analyzed ,and the statistical analysis was performed by using WHONET5 .0 software specified by the bacterial drug resistance surveillance center of WHO .RESULTS Totally 603 strains of E .cloacae have been detected from the 4 137 isolates ,accounting for 14 .6% ,most of which were isolated from the wound secretions (72 .5% ) and puncture fluid (12 .6% ) .During the three years ,the ESBLs‐producing E .cloacae strains accounted for 27 .9% , the AmpC‐producing strains accounted for 18 .7% ,and the strains producing both enzymes accounted for 5 .1% . The drug resistance rates of the strains to imipenem and meropenem were less than 1 .0% ,and the strains were relatively susceptible to cefoperazone‐sulbactam and cefepime .CONCLUSION The strains are highly susceptible to carbapenems ,third ,and fourth generation cephalosporin enzyme inhibitor compounds ,which can be used for the clinical treatment of severe ESBLs‐producing strain infections .