CAJ | 학술논문

目的：分析该院重症监护病房患者弗劳地枸橼酸杆菌医院感染的原因和耐药特点，为今后的临床治疗和预防弗劳地枸橼酸杆菌感染提供依据。方法收集该院2011年12月至2014年11月重症监护病房患者的临床标本，常规分离培养细菌，K‐B纸片法进行药敏试验，利用WHONET 5．6软件分析处理实验数据。结果从重症患者分离的弗劳地枸橼酸杆菌以下呼吸道为主，占64．4％；产ESBLs高，达35．6％；药敏试验表明该菌对亚胺培南、美罗培南、呋喃妥因、卡那霉素、阿米卡星、头孢哌酮／舒巴坦和哌拉西林／他唑巴坦都较敏感，耐药率分别为3．8％、4．5％、8．3％、9．1％、17．4％、18．1％和22．7％，其余抗菌药物的耐药率均大于25．0％。结论弗劳地枸橼酸杆菌引发的重症患者医院感染已日益严重，下呼吸道是其主要感染部位，该菌对临床常用的头孢类、喹诺酮类、氨基糖苷类及多种β‐内酰胺类抗菌药物呈高度耐药，临床应加强耐药性监测，以减少耐药菌株的产生和医院内扩散。
목적：분석해원중증감호병방환자불로지구연산간균의원감염적원인화내약특점，위금후적림상치료화예방불로지구연산간균감염제공의거。방법수집해원2011년12월지2014년11월중증감호병방환자적림상표본，상규분리배양세균，K‐B지편법진행약민시험，이용WHONET 5．6연건분석처리실험수거。결과종중증환자분리적불로지구연산간균이하호흡도위주，점64．4％；산ESBLs고，체35．6％；약민시험표명해균대아알배남、미라배남、부남타인、잡나매소、아미잡성、두포고동／서파탄화고랍서림／타서파탄도교민감，내약솔분별위3．8％、4．5％、8．3％、9．1％、17．4％、18．1％화22．7％，기여항균약물적내약솔균대우25．0％。결론불로지구연산간균인발적중증환자의원감염이일익엄중，하호흡도시기주요감염부위，해균대림상상용적두포류、규낙동류、안기당감류급다충β‐내선알류항균약물정고도내약，림상응가강내약성감측，이감소내약균주적산생화의원내확산。
Objective To analysis of the causes and drug resistance characteristics in ICU patients with Citrobacter freundii hos‐pital infections ,for the future of clinical treatment and prevention of Citrobacter freundii infection provides the basis .Methods Col‐lected our hospitals from December 2011 to November 2014 clinical samples of ICU patients ,conventional isolation and culture of bacteria ,K‐B disk diffusion susceptibility test ,using Whonet5 .6 software analysis processing tentative data .Results Isolated from Critically ill patients Citrobacter freundii lower respiratory tract ,accounted for 64 .4% ;ESBLs producing high ,accounted for 35 .6% ;susceptibility testing showed the bacteria to imipenem ,meropenem ,nitrofurantoin ,kanamycin ,amikacin ,cefoperazone/sul‐bactam and piperacillin/tazobactam were more sensitive ,drug resistance rates were 3 .8% ,4 .5% ,8 .3% ,9 .1% ,17 .4% ,18 .1% and 22 .7% ,the rest of antimicrobial drug resistance rates more than 25 .0% .Conclusion Citrobacter freundii caused critically ill pa‐tients hospital infection have become increasingly serious ,lower respiratory tract was the main site of infection ,the bacteria used in the clinic for cephalosporin ,quinolones ,aminoglycosides and a variety of internal β‐lactam antibiotics were highly resistant ,clinicians should strengthen monitoring of drug resistance ,to reduce the resistant strains produced and spread within the hospital .