CAJ | 학술논문

目的:对产β-ESBLs大肠艾希氏菌和肺炎克雷伯病原菌的耐药性进行统计分析,为临床合理使用抗菌药物提供重要参考依据.方法:采集本院2014年1-12月6931份临床送检标本,对病原菌进行分离培养、鉴定.药敏试验采用K-B法,耐药性分析采用WHONET-5系统.结果:6931份标本中分离出阳性标本2724份.在2724份阳性标本中,分离出大肠埃希菌309株,肺炎克雷伯菌147株;其中产β-ESBLs阳性大肠艾希氏菌234株,分离率75.73%,产β-ESBLs阳性肺炎克雷伯菌71株,分离率48.30%.234株产β-ESBLs阳性大肠艾希氏菌中耐碳青霉烯类抗菌药物的大肠艾希氏菌有20株,占8.75%;71例产β-ESBLs阳性肺炎克雷伯菌中耐碳青霉烯类抗菌药物有10例,占14.08%.两种细菌对碳青霉烯类药物亚胺培南和美洛培南及酶抑制剂哌拉西林/他唑巴坦和头孢哌酮/舒巴坦的耐药率均较低.结论:2014年本院产β-ESBLs大肠艾希氏菌和肺炎克雷伯病原菌分离率较高,出现较高耐药率和多重耐药现象,必须加强对β-ESBLs细菌的耐药性监测,及时准确地为临床提供药敏试验结果,促使临床合理使用抗菌药物,预防产β-ESBLs细菌在院内暴发或流行.
목적:대산β-ESBLs대장애희씨균화폐염극뢰백병원균적내약성진행통계분석,위림상합리사용항균약물제공중요삼고의거.방법:채집본원2014년1-12월6931빈림상송검표본,대병원균진행분리배양、감정.약민시험채용K-B법,내약성분석채용WHONET-5계통.결과:6931빈표본중분리출양성표본2724빈.재2724빈양성표본중,분리출대장애희균309주,폐염극뢰백균147주;기중산β-ESBLs양성대장애희씨균234주,분리솔75.73%,산β-ESBLs양성폐염극뢰백균71주,분리솔48.30%.234주산β-ESBLs양성대장애희씨균중내탄청매희류항균약물적대장애희씨균유20주,점8.75%;71례산β-ESBLs양성폐염극뢰백균중내탄청매희류항균약물유10례,점14.08%.량충세균대탄청매희류약물아알배남화미락배남급매억제제고랍서림/타서파탄화두포고동/서파탄적내약솔균교저.결론:2014년본원산β-ESBLs대장애희씨균화폐염극뢰백병원균분리솔교고,출현교고내약솔화다중내약현상,필수가강대β-ESBLs세균적내약성감측,급시준학지위림상제공약민시험결과,촉사림상합리사용항균약물,예방산β-ESBLs세균재원내폭발혹류행.
Objective:To analyze the drug resistance of β-ESBLs producing escherichia coli and klebsiella pneumonia pathogens,in order to provide important reference for the clinical rational use of antimicrobial agents. Method:6931 clinical specimens were collected in our hospital from January to December 2014.Drug sensitivity test was conducted by using K-B method and WHONET-5 system was used to analyze the distribution of drug resistant pathogens. Result:2724 positive samples were isolated from 6931 specimens.In the 2724 positive samples,309 escherichia coli strains and 147 strains of klebsiella pneumoniae were isolated.Among them β-ESBLs-producing escherichia coli bacteria had 234 strains,the isolation rate was 75.73%,β-ESBLs-producing klebsiella pneumoniae had 71 strains, the isolation rate was 48.30%.20 strains of the 234 β-ESBLs-producing escherichia coli were resistant to carbapenem antibiotics,accounting for 8.75%.10 strains of 71 β-ESBLs-producing positive klebsiella pneumoniae were resistant to carbapenem antibiotics,accounting for 14.08%.The drug resistant rates of the two pathogens to Imipenem,Meropenem, Piperacillin,Tazobactam,Cefoperazone and Sulbactam were lower.Conclusion:In our hospital,the separation rates ofβ-ESBLs-producing escherichia coli and klebsiella pathogenic were higher in 2014.They has high drug resistance rates and multiple drug resistance phenomeno.We must strengthen the monitoring of drug resistance of β-ESBLs-producing bacteria,provide the results of drug sensitivity test for clinical timely and accurately,promote the rational use of antimicrobial drugs,in order to prevent the outbreak or epidemic of β-ESBLs-producing bacteria in nosocomial.