CAJ | 학술논문

目的：探讨IC U中下呼吸道感染患者病原菌分布及耐药性，为临床合理应用抗菌药物提供参考依据。方法对2011年1月－2013年12月医院IC U 500例患者中选择120例下呼吸道患者的痰标本细菌培养结果、鉴定及药敏试验进行回顾性分析，采用SPSS17．0软件进行统计分析。结果120例患者共分离出468株病原菌，其中革兰阴性菌297株占63．46％、革兰阳性菌102株占21．80％、真菌69株占14．74％；革兰阴性菌对头孢哌酮／舒巴坦耐药率低，革兰阳性菌对万古霉素、替考拉宁敏感，其中金黄色葡萄球菌对替考拉宁、夫西地酸及万古霉素的耐药率为0，对其余抗菌药物耐药率均较高达13．16％～100．00％。结论 IC U患者下呼吸道感染病原菌主要以革兰阴性菌为主，多数细菌耐药性严重，临床上应参照药敏试验结果合理应用抗菌药物，加强细菌流行病学监测，以减少耐药现象。
목적：탐토IC U중하호흡도감염환자병원균분포급내약성，위림상합리응용항균약물제공삼고의거。방법대2011년1월－2013년12월의원IC U 500례환자중선택120례하호흡도환자적담표본세균배양결과、감정급약민시험진행회고성분석，채용SPSS17．0연건진행통계분석。결과120례환자공분리출468주병원균，기중혁란음성균297주점63．46％、혁란양성균102주점21．80％、진균69주점14．74％；혁란음성균대두포고동／서파탄내약솔저，혁란양성균대만고매소、체고랍저민감，기중금황색포도구균대체고랍저、부서지산급만고매소적내약솔위0，대기여항균약물내약솔균교고체13．16％～100．00％。결론 IC U환자하호흡도감염병원균주요이혁란음성균위주，다수세균내약성엄중，림상상응삼조약민시험결과합리응용항균약물，가강세균류행병학감측，이감소내약현상。
OBJECTIVE To investigate the distribution and drug resistance of the pathogens in patients with lower respiratory tract infection in intensive care unit (ICU ) so as to provide reference for clinical rational use of antimi‐crobial drugs .METHODS Totally 120 cases with lower respiratory tract infections were chosen from 500 patients in ICU from Jan .2011 to Dec .2013 .The culture results ,identification and drug sensitivity of the bacteria in the sputum samples were retrospectively analyzed .All data were analyzed by SPSS 17 .0 software .RESULTS Totally 468 strains of pathogens were isolated from the 120 cases of patients ,including 297 strains of gram‐negative bacte‐ria ,accounting for 63 .46% ,and 102 strains of gram‐positive bacteria with the share rate of 21 .80% .And fungi had 69 strains ,accounting for 14 .74% .The gram‐negative bacteria had low drug resistance rate to cefoperazone -sulbactam ,while gram‐positive bacteria were mainly sensitive to vancomycin and teicoplanin .Staphylococcus au‐reus were totally sensitive to teicoplanin , fusidic acid and vancomycin , but to the rest antibiotics , the drug resistance rate reached up to 13 .16% -100 .00% .CONCLUSION Gram‐negative bacteria are the main pathogens in lower respiratory tract infections in patients in ICU .Most bacteria are seriously resistant to antibiotics .Drug sensitivity test should be consulted to use antibiotics reasonably in clinic and epidemiological surveillance should be strengthened to reduce the drug resistance .