海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2014年
12期
1783-1786
,共4页
病原微生物%病原菌%耐药性%革兰氏阴性细菌
病原微生物%病原菌%耐藥性%革蘭氏陰性細菌
병원미생물%병원균%내약성%혁란씨음성세균
Inpatient%Pathogenic bacteria%Drug resistance%Gram-negative bacteria
目的：通过对2013年医院住院患者病原微生物检出情况及其耐药性分析，了解医院病原菌检出趋势，为临床合理用药提供依据。方法回顾性分析2013年1~12月微生物实验室检测标本16456份，对送检标本来源分布、病原菌检出结果、细菌耐药性、监测结果进行分析。结果送检标本来源前三位分别为痰液、血液、分泌物。送检样本中阳性样本3614份，阳检率为21.96%。阳性样本中革兰氏阴性菌占66.19%，革兰氏阳性菌占16.6%，真菌占17.21%。病原菌排名前三位分别为大肠埃希菌、肺炎克雷伯氏菌、白色念珠菌。耐药菌监测前三位及其耐药菌检出率为大肠埃希菌(45.04%)、鲍曼不动杆菌(29.04%)、肺炎克雷伯氏菌(25.68%)。结论医院内病原菌以革兰氏阴性细菌为主，革兰氏阴性细菌对β内酰胺类及β内酰胺酶抑制剂的复方制剂、喹诺酮类甚至碳青霉烯类抗菌药物较为敏感。铜绿假单胞菌对喹诺酮类、氨基糖苷类和碳青霉烯类抗菌药物较敏感。革兰氏阳性球菌对青霉素类、大环内酯类耐药率高达75%~100%，真菌对氟康唑、伊曲康唑、伏立康唑耐药率大于74%。
目的：通過對2013年醫院住院患者病原微生物檢齣情況及其耐藥性分析，瞭解醫院病原菌檢齣趨勢，為臨床閤理用藥提供依據。方法迴顧性分析2013年1~12月微生物實驗室檢測標本16456份，對送檢標本來源分佈、病原菌檢齣結果、細菌耐藥性、鑑測結果進行分析。結果送檢標本來源前三位分彆為痰液、血液、分泌物。送檢樣本中暘性樣本3614份，暘檢率為21.96%。暘性樣本中革蘭氏陰性菌佔66.19%，革蘭氏暘性菌佔16.6%，真菌佔17.21%。病原菌排名前三位分彆為大腸埃希菌、肺炎剋雷伯氏菌、白色唸珠菌。耐藥菌鑑測前三位及其耐藥菌檢齣率為大腸埃希菌(45.04%)、鮑曼不動桿菌(29.04%)、肺炎剋雷伯氏菌(25.68%)。結論醫院內病原菌以革蘭氏陰性細菌為主，革蘭氏陰性細菌對β內酰胺類及β內酰胺酶抑製劑的複方製劑、喹諾酮類甚至碳青黴烯類抗菌藥物較為敏感。銅綠假單胞菌對喹諾酮類、氨基糖苷類和碳青黴烯類抗菌藥物較敏感。革蘭氏暘性毬菌對青黴素類、大環內酯類耐藥率高達75%~100%，真菌對氟康唑、伊麯康唑、伏立康唑耐藥率大于74%。
목적：통과대2013년의원주원환자병원미생물검출정황급기내약성분석，료해의원병원균검출추세，위림상합리용약제공의거。방법회고성분석2013년1~12월미생물실험실검측표본16456빈，대송검표본래원분포、병원균검출결과、세균내약성、감측결과진행분석。결과송검표본래원전삼위분별위담액、혈액、분비물。송검양본중양성양본3614빈，양검솔위21.96%。양성양본중혁란씨음성균점66.19%，혁란씨양성균점16.6%，진균점17.21%。병원균배명전삼위분별위대장애희균、폐염극뢰백씨균、백색념주균。내약균감측전삼위급기내약균검출솔위대장애희균(45.04%)、포만불동간균(29.04%)、폐염극뢰백씨균(25.68%)。결론의원내병원균이혁란씨음성세균위주，혁란씨음성세균대β내선알류급β내선알매억제제적복방제제、규낙동류심지탄청매희류항균약물교위민감。동록가단포균대규낙동류、안기당감류화탄청매희류항균약물교민감。혁란씨양성구균대청매소류、대배내지류내약솔고체75%~100%，진균대불강서、이곡강서、복립강서내약솔대우74%。
Objective To analyze the distribution and drug resistance of pathogens so as to investigate the trend of pathogenic bacteria and provide bases for administration. Methods Retrospective analysis of the distribu-tion, result of test, drug resistance and main pathogenic organism in 16 456 tested samples in 2013. Results The main samples are sputum, blood, and secretion with a positive rate of 21.96%, among which the gram-negative bacte-ria accounted for 66.19%, the gram-positive bacteria accounted for 16.6%, and fungi accounted for 17.21%. The main types of bacteria are E.coli, Klebsiella p, Candida albicans. The top three rates of drug resistant bacteria are E.coli (45.04%), Acinetobacter baumannii (29.04%) and klebsiella p. (25.68%). Conclusion Gram-negative bacteria was the main Pathogenic bacteria, which is sensitive toβ-lactams,β-lactamase inhibitor and carbapenems. P aeruginosa is sen-sitive to quinolones, aminoglycosides and carbapenems. The resistant rate of gram positive bacteria to macrolide anti-biotics and penicillin is as high as 75%~100%. Fungus shows high resistance rates to fluconazole, itraconzole and vori-conazole, which were even higher than 74%.
