CAJ | 학술논문

目的：探讨医院感染病原菌耐药现状及中药与抗菌药物对耐药细菌感染疗效，以期为耐药细菌的控制、治疗提供参考。方法选择2014年3－12月发生医院感染的300例患者作为研究对象，分析病原菌种类及其耐药性；将58例耐药菌感染患者随机分为试验组和对照组，各29例，对照组仅用抗菌药物治疗，试验组在抗菌药物基础上配合使用丹参注射液；比较两组患者临床疗效和细菌清除率。结果300例患者共分离出497株病原菌，其中革兰阴性菌222株占44．7％，革兰阳性菌178株占35．8％，真菌97株占19．5％；铜绿假单胞菌对阿米卡星耐药率较低，大肠埃希菌、鲍氏不动杆菌对常用抗菌药物均显示出较高的耐药性；金黄色葡萄球菌对庆大霉素、利奈唑胺耐药率较低，表皮葡萄球菌对利奈唑胺耐药率较低，凝固酶阴性葡萄球菌对万古霉素耐药率较低；治疗1个疗程后，试验组总有效率为96．6％、对照组为89．7％，两组比较差异有统计学意义（ P＜0．05）；试验组细菌清除率为89．7％，对照组为75．0％，两组比较差异有统计学意义（ P＜0．05）。结论医院感染病原菌以革兰阴性菌为主，耐药现象较为严重；中药联合抗菌药物能够显著提高耐药菌感染治疗的临床疗效和细菌清除率，值得推广应用。
목적：탐토의원감염병원균내약현상급중약여항균약물대내약세균감염료효，이기위내약세균적공제、치료제공삼고。방법선택2014년3－12월발생의원감염적300례환자작위연구대상，분석병원균충류급기내약성；장58례내약균감염환자수궤분위시험조화대조조，각29례，대조조부용항균약물치료，시험조재항균약물기출상배합사용단삼주사액；비교량조환자림상료효화세균청제솔。결과300례환자공분리출497주병원균，기중혁란음성균222주점44．7％，혁란양성균178주점35．8％，진균97주점19．5％；동록가단포균대아미잡성내약솔교저，대장애희균、포씨불동간균대상용항균약물균현시출교고적내약성；금황색포도구균대경대매소、리내서알내약솔교저，표피포도구균대리내서알내약솔교저，응고매음성포도구균대만고매소내약솔교저；치료1개료정후，시험조총유효솔위96．6％、대조조위89．7％，량조비교차이유통계학의의（ P＜0．05）；시험조세균청제솔위89．7％，대조조위75．0％，량조비교차이유통계학의의（ P＜0．05）。결론의원감염병원균이혁란음성균위주，내약현상교위엄중；중약연합항균약물능구현저제고내약균감염치료적림상료효화세균청제솔，치득추엄응용。
OBJECTIVE To explore the current status of drug resistance of the pathogens causing nosocomial infec‐tions and observe the effect of traditional Chinese medicine combined with antibiotics on treatment of the infections due to drug‐resistant bacteria so as to provide guidance for control of the drug‐resistant bacteria .METHODS A to‐tal of 300 patients with nosocomial infections who were treated in the hospital from Mar 2014 to Dec 2014 were re‐cruited as the study objects ,then the distribution and drug resistance of the pathogens were analyzed;58 patients with drug‐resistant bacteria infections were randomly divided into the experimental group and the control group , with 29 cases in each;the control group was treated with single antibiotics ,while the experimental group was treated with additional danshen injections based on the antibiotics;the clinical curative effect and bacterial clear‐ance rate were observed and compared between the two groups of patients .RESULTS A total of 497 strains of pathogens have been isolated from the 300 patients ,including 222 (44 .7% ) strains of gram‐negative bacteria ,178 (35 .8% ) strains of gram‐positive bacteria ,and 97 (19 .5% ) strains of fungi .The drug resistance rate of the Pseudomonas aeruginosa to amikacin was relatively low ,the Escherichia coli and Acinetobacter baumannii were highly resistant to the commonly used antibiotics ;the drug resistance rates of the Staphylococcus aureus to genta‐micin and linezolid were relatively low ,the drug resistance rate of the Staphylococcus epidermidis to linezolid was relatively low ,and the drug resistance rate of the coagulase‐negative Staphylococcus to vancomycin was relatively low .One treatment course later ,the total effective rate was 96 .6% in the experimental group ,89 .7% in the con‐trol group ,and there was significant difference between the two groups (P<0 .05);the bacterial clearance rate was 89 .7% in the experimental group ,75 .0% in the control group ,and there was significant difference between the two groups (P<0 .05) .CONCLUSION The gram‐negative bacteria are dominant among the pathogens causing nosocomial infections and are highly drug‐resistant .The traditional Chinese medicine combined with antibiotics can significantly improve the clinical efficacy in treatment of drug‐resistant bacteria infections and the bacterial clear‐ance rate ,and it is worthy to be promoted .