CAJ | 학술논문

目的：了解耐碳青霉烯类肠杆菌科细菌（CRE）感染状况及其产酶类型。方法采用最低抑菌浓度（M IC ）法分析肠杆菌科细菌的耐药情况。采用厄他培南纸片扩散法初筛产碳青霉烯酶菌株，对初筛阳性菌株分别采用改良Hodge试验、加硼酸或苯唑西林的改良Hodge试验、EDTA亚胺培南复合纸片法进行表型确证。结果肠杆菌科细菌对亚胺培南和美罗培南的耐药率分别为2．7％、2．3％。厄他培南纸片扩散法初筛阳性菌株11株，其中改良Hodge确证试验阳性（或弱阳性）菌株3株，包括产金属酶菌株1株，产超广谱β‐内酰胺酶（ESBLs）或AmpC酶菌株2株。2株改良Hodge确证试验弱阳性菌中未检出碳青霉烯酶基因，但检出AmpC、TEM、CTX‐M 基因，改良Hodge试验阳性菌中检出blaIMP基因。结论改良Hodge试验、加硼酸或苯唑西林改良Hodge试验及EDTA亚胺培南复合纸片法相结合进行碳青霉烯酶检测，在暂无条件开展基因分型的医院具有很好的应用前景。
목적：료해내탄청매희류장간균과세균（CRE）감염상황급기산매류형。방법채용최저억균농도（M IC ）법분석장간균과세균적내약정황。채용액타배남지편확산법초사산탄청매희매균주，대초사양성균주분별채용개량Hodge시험、가붕산혹분서서림적개량Hodge시험、EDTA아알배남복합지편법진행표형학증。결과장간균과세균대아알배남화미라배남적내약솔분별위2．7％、2．3％。액타배남지편확산법초사양성균주11주，기중개량Hodge학증시험양성（혹약양성）균주3주，포괄산금속매균주1주，산초엄보β‐내선알매（ESBLs）혹AmpC매균주2주。2주개량Hodge학증시험약양성균중미검출탄청매희매기인，단검출AmpC、TEM、CTX‐M 기인，개량Hodge시험양성균중검출blaIMP기인。결론개량Hodge시험、가붕산혹분서서림개량Hodge시험급EDTA아알배남복합지편법상결합진행탄청매희매검측，재잠무조건개전기인분형적의원구유흔호적응용전경。
Objective To explore the phenotype and drug resistance of carbapenem‐resistant Enterobacteriace‐ae(CRE) .Methods Minimal inhibitory concentration(MIC) method was used to analyze the drug resistance of En‐terobacteriaceae .Kirby‐Bauer (Ertapenem) was used to screen the carbapenemases strains .Improving Hodge experi‐ment ,the one with adding boric acid and Kirby‐Bauer compounding oxacillin and EDTA‐Imipenem were used to con‐firmed the phenotype .Results The drug resistance rate of Enterobacteriacea to imipenem (IPM ) and meropenem (MEM) were 2 .7% and 2 .2% ,in 11 pcs screening positive by Kirby‐Bauer (ETP) ,3 pcs improved Hodge tested positive ,1 pic carbapenemases tested by phenotype ,2 pcs ESBLs or AmpC enzyme .2 pcs weekly positive tested AmpC ,TEM ,and CTX‐M gene ,not carbapenemases .The blaIMP gene were tested .improved Hodge positive plants . Conclusion The corporation of improved Hodge experiment ,the one with adding boric acid and Kirby‐Bauer com‐pounding oxacillin and EDTA‐Imipenem has good performance on CRE testing .