CAJ | 학술논문

目的：分析我院临床病原菌分布及其对抗菌药物体外抗菌活性，为临床合理选用抗菌药物提供依据。方法对2012年1～12月我院住院和门诊患者送检的12708份标本进行分离培养，采用VITEK2-compact全自动细菌分析仪进行鉴定及药敏试验，用WHONET5.6软件进行统计分析。结果12708份临床标本分离出病原菌2828株。其中革兰阳性球菌432株（占15.3％），革兰阴性杆菌1924株（占68.0％）。革兰阳性球菌中排列前3位的分别是金黄色葡萄球菌204株（7.2％）、肠球菌183株（6.5％）、链球菌属100株（3.5％）；革兰阴性杆菌中肠杆菌科细菌排列前3位的分别是大肠埃希氏菌536株（19.0％）、肺炎克雷伯氏菌328株（11.6％）、阴沟肠杆菌184株（6.5％）。非发酵菌中检出最多的为铜绿假单胞菌348株（12.3％），其次为鲍曼不动杆菌228株（8.1％）。葡萄球菌属中MRSA检出率为40.6％，未发现耐万古霉素和利奈唑胺的葡萄球菌；屎肠球菌和粪肠球菌对万古霉素的耐药率分别为4.8％和1.9％，未发现对利奈唑胺耐药的肠球菌；肠杆菌科细菌对碳青霉烯类抗生素高度敏感；铜绿假单胞菌对亚胺培南耐药率为42.7％，鲍曼不动杆菌对亚胺培南的耐药率为53.2％。结论随着广谱抗生素的广泛应用，细菌耐药性问题日趋严重。临床应结合患者状况及实验室药敏报告结果准确合理用药，避免滥用抗生素以防止细菌耐药性增加。
목적：분석아원림상병원균분포급기대항균약물체외항균활성，위림상합리선용항균약물제공의거。방법대2012년1～12월아원주원화문진환자송검적12708빈표본진행분리배양，채용VITEK2-compact전자동세균분석의진행감정급약민시험，용WHONET5.6연건진행통계분석。결과12708빈림상표본분리출병원균2828주。기중혁란양성구균432주（점15.3％），혁란음성간균1924주（점68.0％）。혁란양성구균중배렬전3위적분별시금황색포도구균204주（7.2％）、장구균183주（6.5％）、련구균속100주（3.5％）；혁란음성간균중장간균과세균배렬전3위적분별시대장애희씨균536주（19.0％）、폐염극뢰백씨균328주（11.6％）、음구장간균184주（6.5％）。비발효균중검출최다적위동록가단포균348주（12.3％），기차위포만불동간균228주（8.1％）。포도구균속중MRSA검출솔위40.6％，미발현내만고매소화리내서알적포도구균；시장구균화분장구균대만고매소적내약솔분별위4.8％화1.9％，미발현대리내서알내약적장구균；장간균과세균대탄청매희류항생소고도민감；동록가단포균대아알배남내약솔위42.7％，포만불동간균대아알배남적내약솔위53.2％。결론수착엄보항생소적엄범응용，세균내약성문제일추엄중。림상응결합환자상황급실험실약민보고결과준학합리용약，피면람용항생소이방지세균내약성증가。
Objective To analyze the distribution of clinical common pathogenic bacteria in our hospital and their antibacterial activity in order to provide references for clinical choices of antibiotics .Methods 12708 samples from both inpatients and outpatients in our hospital in Jan .2012 to Dec 2012 were collected and cultured .The identification of bacteria and antibiotics susceptibility tests was performed by using VITEK 2-compact automatic biology analysis .The data was analyzed by WHONET 5.6 .Results Total of 2828 strains of pathogenic bacteria was isolated from 12708 microbial specimens .Gram-positive cocci were accounted for 15.3%,and gram-negative bacilli were accounted for 68%.Among the gram-positive cocci,the top three were staphylococcus aureus (7.2%),enterococ-cus(6.5%) and streptococcus(3.5%),respectively.Among the gram-negative bacilli,the most predominant pathogens were Esche-richia coli(19.0%),klebsiella pneumonia(11.6%) and enterobacter cloacae(6.5%).For non-fermenting gram-negative isolates,the most predominant pathogens were pseudomonas aeruginosa (12.3%) and acinetobacter baumannii (8.1%).In terms of staphylococcus , the detection rate of MRSA was 40.6%.For the resistance rate to vancomycin , enterococcus faecium and enterococcus faecalis were 4.8%and 1.9%,respectively.There was no resistance to linezolid in enterococcus faecium and enterococcus faecalis .Enterobacteriace-ae was maintained high susceptibility to carbopenems .The resistance rate of pseudomonas aeruginosa to inipenem was 42.7%,and acin-etobacter baumannii to imipenem was 53.2%.Conclusion With the widely use of antibiotics ,the resistance of pathogens has become a serious problem .Clinicians should make more reasonable choices of antibiotics according to the patients `symptoms and the results of drug sensitivity test to avoid the antibiotics abuse .