CAJ | 학술논문

目的:了解我院2012年临床分离病原菌的分布特点及其对常用抗菌药物的敏感性和耐药性情况.方法:细菌分离按常规方法进行,抗菌药物敏感试验按 CLSI2012年版进行并判断结果.结果:2156株非重复临床分离菌中:革兰阳性菌735株,占34.1%(735/2156),革兰阴性菌1421株,占65.9%(1421/2156).革兰阳性菌中,金黄色葡萄球菌为分离菌株的第一位.葡萄球菌属细菌中耐甲氧西林金葡菌( MRSA)和耐甲氧西林 CNS(MRCNS)检出率分别为23.1%和85.5%,万古霉素对革兰阳性球菌的抗菌活性最强,未发现万古霉素中介金葡菌(VISA)和耐万古霉素金葡菌 VRSA 菌株.屎肠球菌对测试药物的耐药率普遍高于粪肠球菌,未发现对万古霉素、替加环素、利奈唑胺的耐药株.革兰阴性菌中,大肠埃希菌位居第1位(占28%),肺炎克雷伯菌位居第2位.厄他培南对革兰阴性杆菌的抗菌活性最强,其次亚胺培南.鲍曼不动杆菌对亚胺培南和美罗培南耐药率分别为24.8%和37.3%.铜绿假单胞菌对头孢呋辛酯、头孢唑啉、头孢呋辛、呋喃妥因、头孢替坦、氨苄西林、头孢曲松耐药率较高大于95%,并呈现多重耐药,对其他测试抗生素的耐药率均在20%以下,对亚胺培南和美罗培南耐药率分别为10%和6.8%.结论:微生物检验为临床提供可靠用药依据,合理选用抗菌药物是治疗和预防细菌耐药的关键.
목적:료해아원2012년림상분리병원균적분포특점급기대상용항균약물적민감성화내약성정황.방법:세균분리안상규방법진행,항균약물민감시험안 CLSI2012년판진행병판단결과.결과:2156주비중복림상분리균중:혁란양성균735주,점34.1%(735/2156),혁란음성균1421주,점65.9%(1421/2156).혁란양성균중,금황색포도구균위분리균주적제일위.포도구균속세균중내갑양서림금포균( MRSA)화내갑양서림 CNS(MRCNS)검출솔분별위23.1%화85.5%,만고매소대혁란양성구균적항균활성최강,미발현만고매소중개금포균(VISA)화내만고매소금포균 VRSA 균주.시장구균대측시약물적내약솔보편고우분장구균,미발현대만고매소、체가배소、리내서알적내약주.혁란음성균중,대장애희균위거제1위(점28%),폐염극뢰백균위거제2위.액타배남대혁란음성간균적항균활성최강,기차아알배남.포만불동간균대아알배남화미라배남내약솔분별위24.8%화37.3%.동록가단포균대두포부신지、두포서람、두포부신、부남타인、두포체탄、안변서림、두포곡송내약솔교고대우95%,병정현다중내약,대기타측시항생소적내약솔균재20%이하,대아알배남화미라배남내약솔분별위10%화6.8%.결론:미생물검험위림상제공가고용약의거,합리선용항균약물시치료화예방세균내약적관건.
Objective] To investigate the distribution and antibiotic resistance of bacterial pathogens isolated during the period 2012 in our hospital.[Methods] Clinical isolates were identified and subjected to antimicrobial susceptibility testing by means of a unified protocol. The results were analyzed according to CLSI breakpoints(2012).[Results] Of the 2156 clinical isolates, gram positive and gram negative organisms accounted for34.1 %(735/2156)and65.9 %(1421/2156), respectively. Coagulase negative Staphylococcus (VISA) was the most frequently isolated gram positive bacteria. The prevalence of methicilin-resisitant strains was 23.1 % in Staphylococcus aureus(MRSA), and 85.5% incoagulase-negative Staphylococcus(MRCNS).Vancomycin was the most active antimicrobial agent against gram positive cocci. No BISA or VRSA strain was identified. E. faecium strains was more resistant to most of the antibiotics tested than E. faecalis. No enterococcal strain was resistant to vancomycin or linezolid or tigecycline Escherichia coli were the most frequently isolated gram negative bacteria in our hospital, accounting for 28 %, folowed by Klebsiela strains. Ertapenem was the most active antibacterial agent agent tested against gram negative bacili, folowed by Imipenem strains. About 24.8%and 37.3% of the A. baumanni strains were resistant to imipenem and meropenem, respectively in our hospital. cefoperazone/sulbactam, amikacin and ciprofloxacin. P. aeruginosa showed relatively higher than 95% resistance to Cefuroxime Axetil, Cefazolin, Cefuroxime, Nitrofurantoin, Cefotetan, Ampicilin, and Ceftriaxone . Less than 20% of these P. aeruginosa strains were resistant to other antibiotics. About 10%and 6.8% of the P. aeruginosa strains were resistant to imipenem and meropenem, respectively in our hospital.[Conclusions] The microbial test provide a reliable basis for clinic. Rational antimicrobial therapy is an effective way for control of antimicrobial resistance.