CAJ | 학술논문

目的：了解我院临床分离病原菌的分布特点及其对常用抗菌药物的敏感性和耐药性情况。方法：细菌分离按常规方法进行，抗菌药物敏感试验按CLSI2012年版进行并判断结果。结果：5231株临床分离菌中：革兰阳性菌1236株，占23.6%（1236/5231），革兰阴性菌2147株，占41.0%（2147/5231）。革兰阳性菌中，金黄色葡萄球菌为分离菌株的第一位。葡萄球菌属细菌中耐甲氧西林金葡菌（MRSA）和耐甲氧西林CNS（MRCNS）检出率分别为11.6%和39.5%，万古霉素对革兰阳性球菌的抗菌活性最强，未发现万古霉素中介金葡菌（VISA）和耐万古霉素金葡菌VRSA菌株。屎肠球菌对测试药物的耐药率普遍高于粪肠球菌，未发现对利奈唑胺、替加环素耐药株。革兰阴性菌中，大肠埃希菌位居第1位（占32.1%），肺炎克雷伯菌位居第2位（占17.3%）。厄他培南对革兰阴性肠杆菌的抗菌活性最强，其次是亚胺培南。铜绿假单胞菌对氨苄西林、氨苄西林/舒巴坦、头孢替坦、呋喃妥因、头孢唑啉、头孢呋辛、头孢呋辛酯、头孢曲松的耐药率在97%以上，呈现多重耐药。鲍曼不动杆菌对头孢哌酮/舒巴坦和阿米卡星的耐药率分别是3.7%和8.3%低于亚胺培南耐药率30.8%，对呋喃妥因、头孢唑啉、头孢曲松的耐药率100%，并呈现广泛耐药株。结论：微生物检验为临床提供可靠用药依据，合理选用抗菌药物是治疗和预防细菌耐药的关键。
목적：료해아원림상분리병원균적분포특점급기대상용항균약물적민감성화내약성정황。방법：세균분리안상규방법진행，항균약물민감시험안CLSI2012년판진행병판단결과。결과：5231주림상분리균중：혁란양성균1236주，점23.6%（1236/5231），혁란음성균2147주，점41.0%（2147/5231）。혁란양성균중，금황색포도구균위분리균주적제일위。포도구균속세균중내갑양서림금포균（MRSA）화내갑양서림CNS（MRCNS）검출솔분별위11.6%화39.5%，만고매소대혁란양성구균적항균활성최강，미발현만고매소중개금포균（VISA）화내만고매소금포균VRSA균주。시장구균대측시약물적내약솔보편고우분장구균，미발현대리내서알、체가배소내약주。혁란음성균중，대장애희균위거제1위（점32.1%），폐염극뢰백균위거제2위（점17.3%）。액타배남대혁란음성장간균적항균활성최강，기차시아알배남。동록가단포균대안변서림、안변서림/서파탄、두포체탄、부남타인、두포서람、두포부신、두포부신지、두포곡송적내약솔재97%이상，정현다중내약。포만불동간균대두포고동/서파탄화아미잡성적내약솔분별시3.7%화8.3%저우아알배남내약솔30.8%，대부남타인、두포서람、두포곡송적내약솔100%，병정현엄범내약주。결론：미생물검험위림상제공가고용약의거，합리선용항균약물시치료화예방세균내약적관건。
Objective To investigate the distribution and antibiotic resistance of bacterial pathogens isolated during the period 2014 in our hospital. Methods Clinical isolates were identified and subjected to antimicrobial susceptibility testing by means of a unified protocol. The results were analyzed according to CLSI breakpoints(2012).Results Of the 5231 clinical isolates, gram positive and gram negative organisms accounted for 23.6% (1236/5231 )and 41.0%(2147/5231), respectively. Coagulase negative Staphylococcus (VISA)was the most frequently isolated gram positive bacteria. The prevalence of methicilin-resisitant strains was 11.6% in Staphylococcus aureus(MRSA),and 39.5% in coagulase-negative Staphylococcus(MRCNS).Vancomycin was the most active antimicrobial agent against gram positive cocci. No BISA or VRSA strain was identified. E. faecium strains are more resistant to most of the antibiotics tested than E. faecalis. No strain was resistant to linezolid or tigecycline. Escherichia coli were the most frequently isolated gram negative bacteria in our hospital, accounting for 32.1%, folowed by Klebsiela strains. Ertapenem was the most active antibacterial agent agent tested against gram negative bacili. About 3.7%and 8.3% of the A. baumannii strains were resistant to cefoperazone or shubatan and amikacin,respectively in our hospital,lower than imipenem 30.8%. P. aeruginosa showed relatively lower resistance to ceftazidime, amikacin and ciprofloxacin. More than 97% of these P. aeruginosa strains were resistant to other antibiotics.Conclusions The microbial test provide reliable scientific evidence for clinical medication, which should be paid more attention in clinical and laboratory practice. Rational antimicrobial therapy is a key for control of antimicrobial resistance.