CAJ | 학술논문

目的：了解医院临床分离病原菌的分布及对常用抗菌药物的耐药性，为指导临床合理用药及控制多药耐药菌感染提供依据。方法对2013年1月1日－12月31日临床送检标本进行病原菌培养鉴定及药敏试验，药敏试验采用法国生物梅里埃公司A T B药敏测试仪进行测定，部分药敏试验采用K‐B法。结果28413份送检标本中共分离出病原菌8020株，其中革兰阴性菌6427株占80．1％，革兰阳性菌1288株占16．1％，真菌289株占3．6％，其他16株占0．2％；革兰阳性菌耐药性日趋严重，葡萄球菌属对青霉素G的耐药率已＞90．0％，肠球菌属对头孢类和克林霉素耐药率接近100．0％，未发现耐万古霉素菌株；革兰阴性菌对头孢菌素耐药率较高，肠杆菌科细菌对碳青霉烯类和加酶抑制剂保持较高敏感性。结论病原菌耐药性呈明显上升趋势，多药耐药问题日趋严重，实施有效的病原菌耐药监测，合理使用抗菌药物，对有效控制多药耐药菌感染具有重要意义。
목적：료해의원림상분리병원균적분포급대상용항균약물적내약성，위지도림상합리용약급공제다약내약균감염제공의거。방법대2013년1월1일－12월31일림상송검표본진행병원균배양감정급약민시험，약민시험채용법국생물매리애공사A T B약민측시의진행측정，부분약민시험채용K‐B법。결과28413빈송검표본중공분리출병원균8020주，기중혁란음성균6427주점80．1％，혁란양성균1288주점16．1％，진균289주점3．6％，기타16주점0．2％；혁란양성균내약성일추엄중，포도구균속대청매소G적내약솔이＞90．0％，장구균속대두포류화극림매소내약솔접근100．0％，미발현내만고매소균주；혁란음성균대두포균소내약솔교고，장간균과세균대탄청매희류화가매억제제보지교고민감성。결론병원균내약성정명현상승추세，다약내약문제일추엄중，실시유효적병원균내약감측，합리사용항균약물，대유효공제다약내약균감염구유중요의의。
OBJECTIVE To understand the distribution of clinical isolates of pathogens and observe the drug resist‐ance to the commonly used antibiotics so as to provide guidance for reasonable clinical use of antibiotics and control of multidrug‐resistant bacteria infections .METHODS The pathogens were cultured from the clinical specimens that were submitted from Jan 1 ,2013 to Dec 31 ,2013 ,then the drug susceptibility testing was performed by using ATB susceptibility tester of BioMerieux ,France ,and the drug susceptibility testing for some antibiotics was con‐ducted with the use of K‐B method .RESULTS A total of 8 020 strains of pathogens have been isolated from the 28 413 submitted specimens ,including 6 427 (80 .1% ) strains of gram‐negative bacteria ,1 288 (16 .1% ) strains of gram‐positive bacteria ,289 (3 .6% ) strains of fungi ,and 16 (0 .2% ) strains of other pathogens .The drug resist‐ance of the gram‐positive bacteria was increasingly serious ,the drug resistance of the Staphylococcus spp to peni‐cillinGwasmorethan90.0% ,thedrugresistanceratesoftheEnterococcusspptocephalosporinsandclindamycin were about 100 .0% ,and no strain resistant to vancomycin was found .The gram‐negative bacteria were highly re‐sistant to cephalosporins ,and the Enterobacteriaceae maintained highly susceptible to carbapenems and enzyme in‐hibitors .CONCLUSION The drug resistance of the pathogens shows a significant upward trend ,and the multidrug‐resistant is increasingly serious .It is of great significance to carry out the effective surveillance of drug resistant of the pathogens and reasonably use antibiotics so as to effectively control the multidrug‐resistant bacteria infections .