CAJ | 학술논문

目的：了解山东省中医院2013年至2014年分离革兰阴性杆菌的分布及其耐药性分析，以指导临床对抗菌药物的合理使用。方法：临床标本采用常规分离培养，阳性菌株用VITEK-2进行鉴定及药敏，收集革兰阴性菌株并用WHONET5.6软件进行数据分析。结果：共分离得到6737株革兰阴性杆菌，其中铜绿假单胞菌2160株（32.06%）；大肠埃希菌1013株（15.03%）；粘质沙雷菌947株（14.06%）；鲍曼不动杆菌760株（11.28%）；肺炎克雷伯菌619株（9.19%）。铜绿假单胞菌和鲍曼不动杆菌对多数抗生素均有不同程度的耐药性，对亚胺培南的耐药率分别为46%和70%，多数菌株只对阿米卡星具有敏感性；粘质沙雷菌对β-内酰胺类耐药、对三四代头孢菌素类也有不同程度的耐药性，对亚胺培南的耐药率也达到了11%；大肠埃希菌和肺炎克雷伯菌对抗菌药物特别是碳青霉烯类药物的敏感性总体良好，只有个别菌株对亚胺培南耐药。结论：碳青霉烯类耐药的鲍曼不动杆菌和铜绿假单胞菌检出率较高，粘质沙雷菌对常用抗菌药物的敏感性有下降趋势，临床在选择用药时应考虑这些因素，更合理的使用抗菌药物。
목적：료해산동성중의원2013년지2014년분리혁란음성간균적분포급기내약성분석，이지도림상대항균약물적합리사용。방법：림상표본채용상규분리배양，양성균주용VITEK-2진행감정급약민，수집혁란음성균주병용WHONET5.6연건진행수거분석。결과：공분리득도6737주혁란음성간균，기중동록가단포균2160주（32.06%）；대장애희균1013주（15.03%）；점질사뢰균947주（14.06%）；포만불동간균760주（11.28%）；폐염극뢰백균619주（9.19%）。동록가단포균화포만불동간균대다수항생소균유불동정도적내약성，대아알배남적내약솔분별위46%화70%，다수균주지대아미잡성구유민감성；점질사뢰균대β-내선알류내약、대삼사대두포균소류야유불동정도적내약성，대아알배남적내약솔야체도료11%；대장애희균화폐염극뢰백균대항균약물특별시탄청매희류약물적민감성총체량호，지유개별균주대아알배남내약。결론：탄청매희류내약적포만불동간균화동록가단포균검출솔교고，점질사뢰균대상용항균약물적민감성유하강추세，림상재선택용약시응고필저사인소，경합리적사용항균약물。
Objective:To comprehend the distribution and resistance of gram negative bacilli that separated from 2013 to 2014 in Shandong Chinese Medicine Hospital to guide the clinical rational use of antimicrobial agents. Methods:Clinical specimens isolated using conventional culture and the positive strains identified and their drug susceptibility tested using VITEK-2 . Collected the gram-negative strains and analysized data using WHONET5.6 software.Results:A total of 6737 strains of gram-negative bacilli were isolated,among them,there were strains of Pseudomonas aeruginosa 2160 (32.06%); Escherichia coli 1013 (15.03%); Serratia marcescens 947 (14.06%);Acinetobacter baumannii 760 (11.28%);Klebsiella pneumonia 619 (9.19%).Pseudomonas aeruginosa and Acinetobacter baumannii have different resistance degree to most of the antibiotics and the drug resistance of Imipenem is 46% and 70% respectively,meanwhile most of the strains only have sensitivity to Amikacin. Serratia marcescens resistant to beta lactam, also have varying degrees resistant to the three and four generation cephalosporins, and have 11%Imipenem-resistant rate. E. coli and Klebsiella pneumonia have well drug sensitivity to most of antimicrobial agents ,especially carbapenems, only a few Imipenem-resistant strains. Conclusions:There are high relevance ratios of carbapenems-resistant Pseudomonas aeruginosa and Acinetobacter baumannii. Serratia marcescens have a downtrend sensitivity of common using antimicrobial drugs. So if we want to have more rational use of antimicrobial agents we have to conside these factors when choose drugs.