CAJ | 학술논문

目的：探讨急诊重症监护病房（EICU ）感染患者的病原菌分布及其耐药性，了解EICU目前流行菌株及药物敏感谱，为临床治疗提供参考依据。方法回顾性分析2012－2013年EICU 520例感染患者送检的标本分离出的阳性菌株，采用法国生物梅里埃公司ALERT 3D 60全自动培养仪进行培养，美国BD Phonix 100全自动细菌鉴定仪鉴定菌种及检测耐药性。结果共分离出病原菌348株，革兰阳性菌94株占27．0％，以金黄色葡萄球菌和表皮葡萄球菌居多，革兰阴性菌226株占64．9％，以铜绿假单胞菌、鲍氏不动杆菌、大肠埃希菌及肺炎克雷伯菌居多，真菌28株占8．1％，以曲霉菌属为主；革兰阳性菌对替考拉宁和万古霉素敏感性最好，均无耐药菌株检出，革兰阴性菌对亚胺培南、氨苄西林／舒巴坦较敏感，耐药率＜30．0％。结论医院EICU感染病原菌以革兰阴性菌为主，应加强其耐药性的监测，促进临床合理使用抗菌药物。
목적：탐토급진중증감호병방（EICU ）감염환자적병원균분포급기내약성，료해EICU목전류행균주급약물민감보，위림상치료제공삼고의거。방법회고성분석2012－2013년EICU 520례감염환자송검적표본분리출적양성균주，채용법국생물매리애공사ALERT 3D 60전자동배양의진행배양，미국BD Phonix 100전자동세균감정의감정균충급검측내약성。결과공분리출병원균348주，혁란양성균94주점27．0％，이금황색포도구균화표피포도구균거다，혁란음성균226주점64．9％，이동록가단포균、포씨불동간균、대장애희균급폐염극뢰백균거다，진균28주점8．1％，이곡매균속위주；혁란양성균대체고랍저화만고매소민감성최호，균무내약균주검출，혁란음성균대아알배남、안변서림／서파탄교민감，내약솔＜30．0％。결론의원EICU감염병원균이혁란음성균위주，응가강기내약성적감측，촉진림상합리사용항균약물。
OBJECTIVE To explore and analyze distribution and drug resistance of the pathogenic bacteria for infec‐tions in the emergency intensive care unit (EICU ) of our hospital so as to understand the prevalent strains in EICU and provide reference for clinical treatment .METHODS Positive strains of pathogenic bacterial specimens isolated from 520 infected patients in EICU during Jan .2012 to Dec .2013 were retrospectively analyzed .The France Bi‐oMerieux ALERT 3D 60 automatic culture system was adopted for bacterial culture ,and the American BD Phonix 100 automated bacterial identification system was adopted for identification of bacteria strain distribution and de‐tection of drug resistance .RESULTS Among the 348 isolated pathogenic bacteria ,there were 94 (27 .0% ) strains of gram positive bacteria mainly including Staphylococcus aureus and Staphylococcus epidermidis ,226 (64 .9% ) strains of gram negative bacteria mainly including Pseudomonas aeruginosa , Baumanii , Escherichia coli and Klebsiella pneumoniae ,and 28 (8 .0% ) strains of fungi mainly including Aspergillus .Gram positive bacteria were most sensitive to teicoplanin and vancomycin ,no resistant strains were detected .Gram negative bacteria were sensitive to imipenem and ampicillin/sulbactam with the resistant rate less than 30 .0% .CONCLUSION Pathogenic bacteria in EICU of our hospital were mainly gram negative bacteria ,and monitoring of their drug resistance should be strengthened to promote reasonable use of clinical antibacterial agents .