CAJ | 학술논문

目的：探讨深圳地区多重耐药阴沟肠杆菌的流行状况及耐药机制。方法研究者对临床分离82株阴沟肠杆菌采用超广谱β‐内酰胺酶（ESBLs）表型确证试验和氟氯西林（FCC）双抑制剂扩散协同试验法（DIDST ）分别检测ESBLs、持续高产AmpC酶。结果从82株临床分离的阴沟肠杆菌中，检出33株（占40．2％）产去阻遏持续高产AmpC酶，25株（占30．5％）产ESBLs ，14株（占17．1％）同时表达AmpC酶和ESBLs ，10株（占12．2％）两种酶都不表达。结论高产AmpC酶和ESBLs是阴沟肠杆菌对头孢菌素耐药的主要机制，高产AmpC酶和ESBLs的产生与β酰胺类抗菌药物的广泛应用有着直接关系，临床治疗多重耐药阴沟肠杆菌应首选碳青霉烯类药物。
목적：탐토심수지구다중내약음구장간균적류행상황급내약궤제。방법연구자대림상분리82주음구장간균채용초엄보β‐내선알매（ESBLs）표형학증시험화불록서림（FCC）쌍억제제확산협동시험법（DIDST ）분별검측ESBLs、지속고산AmpC매。결과종82주림상분리적음구장간균중，검출33주（점40．2％）산거조알지속고산AmpC매，25주（점30．5％）산ESBLs ，14주（점17．1％）동시표체AmpC매화ESBLs ，10주（점12．2％）량충매도불표체。결론고산AmpC매화ESBLs시음구장간균대두포균소내약적주요궤제，고산AmpC매화ESBLs적산생여β선알류항균약물적엄범응용유착직접관계，림상치료다중내약음구장간균응수선탄청매희류약물。
Objective To explore the prevalence and antimicrobial resistance mechanism of multiple drug resistance Enterobacter cloacae in ShenZhen region .Methods We screened 72 strains of multi resistant strains from 82 strains of Enterobacter cloacae iso‐lated from on clinical .And detected extended spectrum beta lactamases (ESBLs) and sustained high AmpC enzyme with ESBLs phenotypic confirmatory test and flucloxacillin (FCC ) double inhibitor diffusion synergy test method (DIDST ) .Results In 82 strains of Enterobacter cloacae isolated on clinical ,33 strains (40 .2% ) derepressed Hyperproducing AmpC enzymes ,25 strains (30 .5% ) produced ESBLs ,14 strains (17 .1% ) produced AmpC enzyme and ESBLs parallelly ,10 strains (12 .2% ) didn′t express the two enzymes .Conclusion High expression of AmpC enzyme and ESBLs is the main mechanism of cephalosporin resistant En‐terobacter cloacae .High AmpC enzyme and ESBLs production and widely used of beta amide antibacterial drug have a direct rela‐tionship .The first choice of treatment of multi drug resistant Enterobacter cloacae should be carbapenem .