CAJ | 학술논문

目的了解2006-2008年我院老年患者分离菌株对常用抗菌药物的耐药性.方法采用纸片扩散法,对老年患者分离菌5710株进行药物敏感性试验,WHONET5.4统计软件对数据进行分析.结果分离革兰阴性杆菌前3位分别为铜绿假单胞菌、大肠埃希菌和嗜麦芽窄食单胞菌;革兰阳性球菌前4位分别为金黄色葡萄球菌、凝固酶阴性葡萄球菌、肺炎链球菌及肠球菌属.体外药物敏感性试验结果显示.121株肺炎链球菌中,19株为青霉素不敏感株,占15.7%;690株金黄色葡萄球菌中.对甲氧西林耐药的金黄色葡萄球菌占80.2%;未发现对万古霉素不敏感的葡萄球菌.分离到114株粪肠球菌和95株屎肠球菌,屎肠球菌的耐药性高于粪肠球菌,其中对万古霉素耐药的肠球菌19株.2006年、2007年和2008年产超广谱β-内酰胺酶(ESBLs)大肠埃希菌分离率分别为41.7%、55.0%和56.8%,肺炎克雷伯菌分别为16.0%、22.4%和27.3%,产ESBLs菌株的耐药性远高于非ESBLs菌株.铜绿假单胞菌和不动杆菌属已出现多重耐药株.结论老年患者分离致病菌耐药性高于非老年平均水平.定期进行耐药监测有助于了解老年患者细菌耐药性变迁,为临床经验用药提供理论依据.
목적 료해2006-2008년아원노년환자분리균주대상용항균약물적내약성.방법 채용지편확산법,대노년환자분리균5710주진행약물민감성시험,WHONET5.4통계연건대수거진행분석.결과 분리혁란음성간균전3위분별위동록가단포균、대장애희균화기맥아착식단포균;혁란양성구균전4위분별위금황색포도구균、응고매음성포도구균、폐염련구균급장구균속.체외약물민감성시험결과현시.121주폐염련구균중,19주위청매소불민감주,점15.7%;690주금황색포도구균중.대갑양서림내약적금황색포도구균점80.2%;미발현대만고매소불민감적포도구균.분리도114주분장구균화95주시장구균,시장구균적내약성고우분장구균,기중대만고매소내약적장구균19주.2006년、2007년화2008년산초엄보β-내선알매(ESBLs)대장애희균분리솔분별위41.7%、55.0%화56.8%,폐염극뢰백균분별위16.0%、22.4%화27.3%,산ESBLs균주적내약성원고우비ESBLs균주.동록가단포균화불동간균속이출현다중내약주.결론 노년환자분리치병균내약성고우비노년평균수평.정기진행내약감측유조우료해노년환자세균내약성변천,위림상경험용약제공이론의거.
Objective To analyze the antibiotic resistance of clinical isolated bacteria in elderly inpatients in Beijing Hospital from 2006 to 2008.Methods A total of 5710 strains isolated from elderly inpatients received antibiotic sensitivity test (AST) by using K-B method, and the data were analyzed with WHONET 5.4 software.Results During the 3 years, in constituent ratio of bacteria, P.aeruginosa, E.coli and Stenotrophomonas maltophilia were at the top of gram-negative bacteria.And S.aureus, coagulase-negative Staphylococcus (CONS), S.pneumoniae and Enterococcus spp.were at the top of gram-positive bacteria.The results of AST in vitro showed that 19 of 121 strains of S.pneumoniae were penicillin-insensitive S.pneumoniae (PNSP).In 690 strains of S.aureus, the methicillin-resistant S.aureus (MRSA) ratio was 80.2%, and vancomycin-insensitive strains were not found.And 114 strains of Enterococeus faecalis and 95 strains of Enterococcus faecalis were isolated, while the antibiotic resistance of the latter was stronger than the former, and 19 strains were vancomycin-resistant strains.The detection ratios of E.colt producing ESBLs were 41.7%, 55.0% and 56.8%, and the detection ratios of Klebiella pneumonia producing ESBLs were 16.0%, 22.4% and 27.3 %.The antibiotic resistance of ESBL-producing bacteria was much stronger than non-ESBLs producing bacteria.Multi-antibiotic resistant strains of Pseudomonas aeruginosa and Acinetobacter spp.were found.Conclusions It is necessary to detect the drug-resistant strains periodically for understanding the changes in bacterial resistance and providing a theoretical basis for the medication by the clinical experience.