CAJ | 학술논문

目的：统计北京市海淀医院2012年度血流感染病原菌分布和细菌耐药情况。方法对北京市海淀医院2012年1月1日至2012年12月31日收集的血标本进行细菌、真菌分离培养及鉴定，用WHO-NET 5.6软件以及SPSS 12.0进行描述性统计分析。结果北京市海淀医院2012年度共分离病原菌156株，其中，革兰阳性菌株70株（44.9%），革兰阴性菌株83株（53.2%）。常见细菌依次为大肠埃希菌32.1%（50/156）、凝固酶阴性葡萄球菌28.8%（45/156）、肺炎克雷伯菌9.0%（14/156）和金黄色葡萄球菌6.4%（10/156）。葡萄球菌中耐甲氧西林金黄色葡萄球菌占9.1%（10/55），凝固酶阴性葡萄球菌占81.8%（45/55）。大肠埃希菌和肺炎克雷伯菌对青霉素、第1、2代头孢菌素耐药率较高，为38%～85%。对喹诺酮类药物，大肠埃希菌耐药率50%～60%，肺炎克雷伯菌耐药率为15%～30%。葡萄球菌对β-内酰胺类、大环内酯类、氨基糖苷类和喹诺酮类等抗菌药的总体耐药率为30%～86%，未发现对万古霉素及利奈唑胺耐药菌株。结论2012年度血培养分离细菌耐药是普遍现象，应加强细菌性耐药性监测，为临床合理规范使用抗菌药物提供参考。
목적：통계북경시해정의원2012년도혈류감염병원균분포화세균내약정황。방법대북경시해정의원2012년1월1일지2012년12월31일수집적혈표본진행세균、진균분리배양급감정，용WHO-NET 5.6연건이급SPSS 12.0진행묘술성통계분석。결과북경시해정의원2012년도공분리병원균156주，기중，혁란양성균주70주（44.9%），혁란음성균주83주（53.2%）。상견세균의차위대장애희균32.1%（50/156）、응고매음성포도구균28.8%（45/156）、폐염극뢰백균9.0%（14/156）화금황색포도구균6.4%（10/156）。포도구균중내갑양서림금황색포도구균점9.1%（10/55），응고매음성포도구균점81.8%（45/55）。대장애희균화폐염극뢰백균대청매소、제1、2대두포균소내약솔교고，위38%～85%。대규낙동류약물，대장애희균내약솔50%～60%，폐염극뢰백균내약솔위15%～30%。포도구균대β-내선알류、대배내지류、안기당감류화규낙동류등항균약적총체내약솔위30%～86%，미발현대만고매소급리내서알내약균주。결론2012년도혈배양분리세균내약시보편현상，응가강세균성내약성감측，위림상합리규범사용항균약물제공삼고。
Objective To investigate the bacterial distribution and drug resistance in bloodstream infection.Methods All of the bacterial susceptibility results from January 1st to December 31st, 2012 in Beijing Haidian Hospital were collected by unified protocol and the data were analyzed by software WHONET 5.6 and SPSS12.0.Results Total of 156 isolates and their antibacterial susceptibility data were collected,which included 83 (53.2%) gram-negative bacterial strains and 70 (44.9%) gram-positive bacterial strains.Escherichia coli(50/156, 32.1%), Coagulase negativeStaphylococcus (45/156, 28.8%),Klebsiella pneumoniae (14/156, 9.0%),Staphylococcus aureus (10/156, 6.4%) were the most common isolates. The incidences of meticillin-resistantStaphylococcus aureus (MRSA) and coagulase negativeStaphylococcus (MRSCN) were 9.1% and 81.8%, respectively. The resistance rates ofEscherichia coli andKlebsiella pneumoniae to penicillin and 1 or 2 generation cephamycins were 38%-85%. The resistance rates of Escherichia coli andKlebsiella pneumoniae to quinolinones were 50%-60% and 15%-30%, respectively. No vancomycin and linezolid resistantStaphylococcus strains were found.Conclusions Bacterial resistance was common according to this report, thus we should enhance bacterial resistance monitoring for clinical rational use of antimicrobial agents.