CAJ | 학술논문

目的：了解血培养主要病原菌的分布及其耐药性。方法采用MicroScan WalkAway 96 PLUS及VITEK 2 compact全自动微生物鉴定及药敏系统对阳性分离菌进行鉴定及药敏试验。按CLSI 2013标准采用WHONET 5．6软件进行耐药性分析，IBM SPSS 20．0进行耐药率的比较。结果503株非重复分离菌中，革兰阳性菌占57．8％，革兰阴性菌占36．0％，真菌占6．2％。凝固酶阴性葡萄球菌（CNS）、大肠埃希菌、肠球菌属、金黄色葡萄球菌（金葡菌）和肺炎克雷伯菌是主要分离菌。耐甲氧西林金葡菌（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（ MRCNS ）的检出率分别为32．3％和71．7％。分离自ICU患者的CNS对多种抗菌药物的耐药率高于非ICU患者分离株（P＜0．05）。大肠埃希菌和肺炎克雷伯菌对常用头孢菌素类抗生素耐药率较高，但对哌拉西林-他唑巴坦、亚胺培南和阿米卡星耐药率低。鲍曼不动杆菌对常用抗菌药物的耐药率高。念珠菌属对抗真菌药物耐药率低。结论血培养阳性分离菌分布广泛，不同病原菌间耐药性亦不相同。应加强对血培养病原菌分布和耐药性的监测。
목적：료해혈배양주요병원균적분포급기내약성。방법채용MicroScan WalkAway 96 PLUS급VITEK 2 compact전자동미생물감정급약민계통대양성분리균진행감정급약민시험。안CLSI 2013표준채용WHONET 5．6연건진행내약성분석，IBM SPSS 20．0진행내약솔적비교。결과503주비중복분리균중，혁란양성균점57．8％，혁란음성균점36．0％，진균점6．2％。응고매음성포도구균（CNS）、대장애희균、장구균속、금황색포도구균（금포균）화폐염극뢰백균시주요분리균。내갑양서림금포균（MRSA）화내갑양서림응고매음성포도구균（ MRCNS ）적검출솔분별위32．3％화71．7％。분리자ICU환자적CNS대다충항균약물적내약솔고우비ICU환자분리주（P＜0．05）。대장애희균화폐염극뢰백균대상용두포균소류항생소내약솔교고，단대고랍서림-타서파탄、아알배남화아미잡성내약솔저。포만불동간균대상용항균약물적내약솔고。념주균속대항진균약물내약솔저。결론혈배양양성분리균분포엄범，불동병원균간내약성역불상동。응가강대혈배양병원균분포화내약성적감측。
Objective To investigate the distribution and antibiotic resistance of the pathogens isolated from blood culture . Methods Identification and antimicrobial susceptibility testing were performed with MicroScan WalkAway 96 PLUS or VITEK 2 compact .WHONET 5 .6 software was used for analysis of the susceptibility data according to CLSI 2013 breakpoints .IBM SPSS 20 .0 was employed to compare the resistance rates between groups . Results Gram-positive bacteria , gram-negative bacteria and fungi accounted for 57 .8% ,36 .0% and 6 .2% of the 503 nonduplicate isolates ,respectively .The most common isolates included coagulase-negative Staphylococcus , Escherichia coli , Enterococcus spp ., Staphylococcus aureus and K lebsiella pneumoniae . The prevalence of methicillin-resistant S . aureus (MRSA ) and coagulase-negative Staphylococcus (MRSCN) was 32 .3% and 71 .7% respectively .The coagulase-negative Staphylococcus isolates from ICU patients showed higher resistance rates to many antibiotics than those non-ICU strains (P<0 .05) .E .coli and K .pneumoniae strains showed high percentage of resistance to cephalosporins , but relatively low resistance to piperacillin-tazobactam , imipenem and amikacin .A .baumannii isolates were highly resistant to most antimicrobial agents . Candida species were less resistant to antifungal agents .Conclusions The pathogens isolated from blood culture are diverse .The resistance profile is quite different among various pathogens .The distribution and antibiotic resistance should be actively monitored for the pathogens isolated from blood culture in order to facilitate the rational use of antimicrobial agents .