CAJ | 학술논문

目的：调查我院骨科病区抗菌药物的应用及细菌学情况，为提高抗菌药物合理应用水平提供依据。方法：采用回顾性调查方法，对骨科病区2013年1-12月抗菌药物的使用情况、细菌学检查结果及其耐药性进行统计、分析。结果：各类抗菌药物使用按用药频度（DDDs）排序，前3位分别为头孢菌素类（9536.4）、青霉素类（613.9）和喹诺酮类（445.0）；抗菌药物前3位分别为头孢硫脒（3036.7）、头孢唑林（2293.0）、头孢呋辛（1688.5）。2013年骨科病区送检标本检出的146株细菌中，G-菌100株（68.5%），主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌；G+菌31株（21.2%），主要为金黄色葡萄球菌；真菌15株（10.3%），主要为白色念珠菌。检出菌株中G+菌药物敏感率较高， G-菌和真菌对DDDs排序前列的药物敏感率较低。结论：2013年度我院骨科病区抗菌药物的使用没有导致常见感染菌株出现广泛耐药。骨科病区严格把握抗菌药物使用指征，相对合理的用法用量，是细菌耐药率较低的主要原因；中药的辨证使用是骨科病区细菌耐药率低的可能原因之一。
목적：조사아원골과병구항균약물적응용급세균학정황，위제고항균약물합리응용수평제공의거。방법：채용회고성조사방법，대골과병구2013년1-12월항균약물적사용정황、세균학검사결과급기내약성진행통계、분석。결과：각류항균약물사용안용약빈도（DDDs）배서，전3위분별위두포균소류（9536.4）、청매소류（613.9）화규낙동류（445.0）；항균약물전3위분별위두포류미（3036.7）、두포서림（2293.0）、두포부신（1688.5）。2013년골과병구송검표본검출적146주세균중，G-균100주（68.5%），주요위대장애희균、폐염극뢰백균、동록가단포균；G+균31주（21.2%），주요위금황색포도구균；진균15주（10.3%），주요위백색념주균。검출균주중G+균약물민감솔교고， G-균화진균대DDDs배서전렬적약물민감솔교저。결론：2013년도아원골과병구항균약물적사용몰유도치상견감염균주출현엄범내약。골과병구엄격파악항균약물사용지정，상대합리적용법용량，시세균내약솔교저적주요원인；중약적변증사용시골과병구세균내약솔저적가능원인지일。
ABSTRACTObjective:To investigate the application of antimicrobial drugs and bacteriology in orthopedics de-partment of our hospital so as to provide a clinical reference for the rational use of antimicrobial agents.Methods:The application of antimicrobial drugs,the results of bacterial examination and bacterial resistance in orthopedics department of our hospital in 2013 were analyzed statistically by a retrospective investigation method.Results:The top three drug categories based on the DDDs sequence of the use of antibacterials were cephalosporins(9 536.4), penicillins(613.9)and quinolones(445.0),and the top three drugs were cefathiamidine(3 036.7),cefazolin (2 293.0)and cefuroxime(1 688.5). In l46 strains of detected bacteria,100 strains were Gram-negative bacteria (68.5%),includingEscherichiacoli,KlebsiellapneumoniaeandPseudomonasaeruginosa,31 strains were Gram-positive bacteria(21.2%)which was mainlyStaphylococcus,and 15 strains of fungi(10.3%),of which Candidaalbicanswas the main part. The drug sensitive rate of Gram-positive bacteria was higher,but Gram-nega-tive bacteria and fungi had a lower drug sensitivity rate of antimicrobial agents ranked at forefront of DDDs.Con-clusion:The application of antimicrobial drugs did not lead to an extensive bacterial resistance in orthopedics de-partment of our hospital in 2013. The strict grasp of drug use indications and reasonable administration of antimicro-bial drugs were critical points to obtain a low rate of bacterial resistance. Traditional Chinese medicine syndrome differentiation was one of the possible reasons.