CAJ | 학술논문

目的：探讨军事医学科学院附属医院感染性疾病中主要菌群分布特点及耐药现状，为临床医师经验用药提供参考依据。方法回顾性分析近1年该院住院患者病原菌的感染情况。结果3815株病原菌中，革兰阴性杆菌占63．6％，革兰阳性菌占36．4％。最常见的细菌种类依次为大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌、铜绿假单胞菌和表皮葡萄球菌。肠杆菌科细菌对碳青霉烯类抗生素仍高度敏感，总耐药率为2％～5％。鲍氏不动杆菌对亚胺培南和美罗培南的耐药率为60％。肺炎克雷伯菌、鲍氏不动杆菌和铜绿假单胞菌中仍有少数泛耐药株。葡萄球菌属中未发现万古霉素、替加环素和利奈唑胺耐药株。耐万古霉素屎肠球菌为9％，主要分布于呼吸重症监护、血液和肿瘤科。标本来源以痰标本为主。结论病原菌分布的科室较为集中与该院收治的患者病种有关；病原菌的检出以下呼吸道标本为主，种类繁多，细菌耐药现象较为普遍，耐万古霉素肠球菌、耐碳青霉烯类肺炎克雷伯菌检出率较高。
목적：탐토군사의학과학원부속의원감염성질병중주요균군분포특점급내약현상，위림상의사경험용약제공삼고의거。방법회고성분석근1년해원주원환자병원균적감염정황。결과3815주병원균중，혁란음성간균점63．6％，혁란양성균점36．4％。최상견적세균충류의차위대장애희균、폐염극뢰백균、포씨불동간균、동록가단포균화표피포도구균。장간균과세균대탄청매희류항생소잉고도민감，총내약솔위2％～5％。포씨불동간균대아알배남화미라배남적내약솔위60％。폐염극뢰백균、포씨불동간균화동록가단포균중잉유소수범내약주。포도구균속중미발현만고매소、체가배소화리내서알내약주。내만고매소시장구균위9％，주요분포우호흡중증감호、혈액화종류과。표본래원이담표본위주。결론병원균분포적과실교위집중여해원수치적환자병충유관；병원균적검출이하호흡도표본위주，충류번다，세균내약현상교위보편，내만고매소장구균、내탄청매희류폐염극뢰백균검출솔교고。
Objective To investigate the flora distribution and drug resistance status in the Affiliated Hospital of Academy of Military Medical Sciences so as to provide experimental data for clinical doctors to use antibiotics more efficiently.Methods The clinical data of pathogenic bacterial infections over nearly one year in our hospital were retro -spectively analyzed .Results There were 3815 strains of pathogenic bacteria isolated from the sample .The percentage of Gram-positive strains was 36.4%while that of Gram-negative bacteria was 63.6%.The most common bacteria were Esche-richia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus epidermidis.In terms of drug tolerance , Enterobacteriaceae remained highily sensitive to carbapenems .The total resistance rate was 2%-5%.The resistance rate of A.baumannii to meropenem and imipenem was 60%.There were still a few pan-drug resistant strains among K.pneumoniae,A.baumannii and P.aeruginosa,but there were no drug resistant strains to vancomycin , tige-cycline and linezolid in Staphylococcus.The resistance rate of Enterococcus faecium to vancomycin was 9%.The bacteria were distributed predominantly in ICU ,Department of Hematology and Department of Oncology .The samples were mainly composed of phlegm specimens .Conclusion The high distribution in the three departments mentioned above is largely re-lated to the diseases being treated .The specimens from the lower respiratory tract show more types of bacteria that are mostly drug-resistant, and the isolating rate of vancomycin resistant Enterococcus and carbapenems resistant K.pneumoniat is com-paratively high .