CAJ | 학술논문

目的：分析长海医院2009年1月至2013年12月血流感染病原菌的菌种构成比、临床分布及耐药性分析，指导临床合理使用抗菌药物。方法采用VITEK2‐Compact系统鉴定细菌及药敏试验。采用WHONET5．6软件分析血培养标本所分离的病原菌分布情况和药敏试验结果。结果1641株血流感染病原菌中，革兰阳性菌373株（22．74％），肠杆菌科细菌933株（56．85％），非发酵菌291株（17．73％），真菌44株（2．68％）。分离率为前5位的病原菌分别是大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和凝固酶阴性葡萄球菌。药敏试验结果显示，耐甲氧西林金黄色葡萄球菌为61．70％，未发现对万古霉素耐药的葡萄球菌，耐万古霉素肠球菌为4．23％，肺炎克雷伯菌对亚胺培南耐药率达到13．30％，非发酵菌表现为多重耐药。结论长海医院血流感染以肠杆菌科细菌为主，其次为阳性球菌和非发酵菌，除细菌外，念珠菌血流感染也越来越常见，临床应重视血流感染的病原菌及耐药趋势，控制院内感染。
목적：분석장해의원2009년1월지2013년12월혈류감염병원균적균충구성비、림상분포급내약성분석，지도림상합리사용항균약물。방법채용VITEK2‐Compact계통감정세균급약민시험。채용WHONET5．6연건분석혈배양표본소분리적병원균분포정황화약민시험결과。결과1641주혈류감염병원균중，혁란양성균373주（22．74％），장간균과세균933주（56．85％），비발효균291주（17．73％），진균44주（2．68％）。분리솔위전5위적병원균분별시대장애희균、폐염극뢰백균、포만불동간균、동록가단포균화응고매음성포도구균。약민시험결과현시，내갑양서림금황색포도구균위61．70％，미발현대만고매소내약적포도구균，내만고매소장구균위4．23％，폐염극뢰백균대아알배남내약솔체도13．30％，비발효균표현위다중내약。결론장해의원혈류감염이장간균과세균위주，기차위양성구균화비발효균，제세균외，념주균혈류감염야월래월상견，림상응중시혈류감염적병원균급내약추세，공제원내감염。
Objective To analyze the composition ratio ,clinical distribution and drug resistance of pathogens i‐solated from bloodstream infections (BSIs) from Shanghai Changhai hospital for guiding rational use of antibacterial drugs in clinic .Methods The identification and antimicrobial susceptibility test of pathogens causing BSIs were per‐formed by using the VITEK 2‐Compact system .The obtained data were processed with WHONET5 .6 software for evaluating the clinical distribution and drug resistance of isolated pathogens .Results Among 1 641 strains of blood‐stream infection pathogens ,373 strains(22 .74% ) were Gram‐positive bacteria ,933 strains (56 .85% ) were Enter‐obacteriaceae bacteria ,291 strians (17 .73% ) were non‐fermenters and 44 strains (2 .68% ) were fungi .The top 5 pathogens in the isolation rates were Escherichia coli ,Klebsiella pneumoniae ,Acinetobacter baumannii ,Pseudomonas aeruginosa and coagulase‐negative staphylococci (CoNS) .The antimicrobial susceptibility test showed that 61 .70% i‐solated strains of staphylococci aures were resistant to methicillin;4 .23% isolated strains of enterococci feces were resistant to vancomycin;13 .30% isolated strains of Klebsiella pneumoniae were resistant to carbapenems ;most isola‐ted strains of non‐fermenters bacteria were multi‐drug resistant .Conclusion The most common pathogens of BSIs in Changhai hospital are dominated by enterobacteriaceae bacteria ,followed by Gram‐positive bacteria and non‐fermenta‐tive bacteria .In addition to bacteria ,candidemia are more and more common in nosocomial bloodstream infection .In‐creasing attention should be paid to the pathogens causing bloodstream infections and their drug resistant trend for controlling the nosocomial infections .