中国感染控制杂志
中國感染控製雜誌
중국감염공제잡지
CHINESE JOURNAL OF INFECTION CONTROL
2015年
4期
245-248
,共4页
老年科%病原菌%抗药性,微生物%抗菌药物%合理用药
老年科%病原菌%抗藥性,微生物%抗菌藥物%閤理用藥
노년과%병원균%항약성,미생물%항균약물%합리용약
geriatrics department%pathogen%drug resistance,microbial%antimicrobial agent%rational drug use
目的：了解某院老年科2013年临床分离病原菌分布及耐药性，为临床用药提供参考。方法对2013年1—12月老年科患者送检临床标本中分离的病原菌分布及耐药情况进行统计分析。结果1896株病原菌中，革兰阴性（G－）菌1289株（占67．99％），革兰阳性（G＋）菌493株（占26．00％），真菌114株（占6．01％）；其中，居前4位的病原菌分别是肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌。大肠埃希菌、肺炎克雷伯菌产超广谱β-内酰胺酶（ESBLs）检出率分别为53．26％、31．10％；金黄色葡萄球菌和表皮葡萄球菌耐甲氧西林检出率分别为22．47％、80．00％，肠球菌耐万古霉素检出率为3．10％。肺炎克雷伯菌、肠杆菌科细菌对亚胺培南、美罗培南、厄他培南均高度敏感。鲍曼不动杆菌对亚胺培南的耐药率为79．48％，对美罗培南的耐药率为80．35％，对铜绿假单胞菌耐药率最低的是阿米卡星（10．70％）。G＋球菌对万古霉素、利奈唑胺敏感性高。结论老年患者病原菌以 G－菌为主，耐药情况严重，开展细菌耐药性监测，对指导临床合理使用抗菌药物，控制细菌耐药有重要意义。
目的：瞭解某院老年科2013年臨床分離病原菌分佈及耐藥性，為臨床用藥提供參攷。方法對2013年1—12月老年科患者送檢臨床標本中分離的病原菌分佈及耐藥情況進行統計分析。結果1896株病原菌中，革蘭陰性（G－）菌1289株（佔67．99％），革蘭暘性（G＋）菌493株（佔26．00％），真菌114株（佔6．01％）；其中，居前4位的病原菌分彆是肺炎剋雷伯菌、銅綠假單胞菌、鮑曼不動桿菌、大腸埃希菌。大腸埃希菌、肺炎剋雷伯菌產超廣譜β-內酰胺酶（ESBLs）檢齣率分彆為53．26％、31．10％；金黃色葡萄毬菌和錶皮葡萄毬菌耐甲氧西林檢齣率分彆為22．47％、80．00％，腸毬菌耐萬古黴素檢齣率為3．10％。肺炎剋雷伯菌、腸桿菌科細菌對亞胺培南、美囉培南、阨他培南均高度敏感。鮑曼不動桿菌對亞胺培南的耐藥率為79．48％，對美囉培南的耐藥率為80．35％，對銅綠假單胞菌耐藥率最低的是阿米卡星（10．70％）。G＋毬菌對萬古黴素、利奈唑胺敏感性高。結論老年患者病原菌以 G－菌為主，耐藥情況嚴重，開展細菌耐藥性鑑測，對指導臨床閤理使用抗菌藥物，控製細菌耐藥有重要意義。
목적：료해모원노년과2013년림상분리병원균분포급내약성，위림상용약제공삼고。방법대2013년1—12월노년과환자송검림상표본중분리적병원균분포급내약정황진행통계분석。결과1896주병원균중，혁란음성（G－）균1289주（점67．99％），혁란양성（G＋）균493주（점26．00％），진균114주（점6．01％）；기중，거전4위적병원균분별시폐염극뢰백균、동록가단포균、포만불동간균、대장애희균。대장애희균、폐염극뢰백균산초엄보β-내선알매（ESBLs）검출솔분별위53．26％、31．10％；금황색포도구균화표피포도구균내갑양서림검출솔분별위22．47％、80．00％，장구균내만고매소검출솔위3．10％。폐염극뢰백균、장간균과세균대아알배남、미라배남、액타배남균고도민감。포만불동간균대아알배남적내약솔위79．48％，대미라배남적내약솔위80．35％，대동록가단포균내약솔최저적시아미잡성（10．70％）。G＋구균대만고매소、리내서알민감성고。결론노년환자병원균이 G－균위주，내약정황엄중，개전세균내약성감측，대지도림상합리사용항균약물，공제세균내약유중요의의。
Objective To investigate the distribution and antimicrobial resistance of clinically isolated pathogens from geriatrics department of a hospital in 2013,so as to provide reference for clinical antimicrobial use.Methods Distribution and antimicrobial resistance of pathogens isolated from patients in a geriatrics department between Janu-ary and December 2013 were analyzed statistically.Results Of 1 896 pathogenic strains,1 289(67.99%)were gram-negative bacteria,439 (26.00%)were gram-positive bacteria,and 114(6.01%)were fungi;the top 4 isolated pathogens were Klebsiella pneumoniae ,Pseudomonas aeruginosa ,Acinetobacter baumannii ,and Escherichia coli .Extended-spec-trumβ-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae accounted for 53.26% and 31.10% of Escherichia coli and Klebsiella pneumoniae respectively;Of Staphylococcus aureus and Staphylococcus epidermidis strains,methicillin-resistant isolates (MRSA and MRSE)accounted for 22.47% and 80.00%,respectively,of Enterococ-cus strains,vancomycin-resistant isolates (VRE)was 3.10%,Klebsiella pneumoniae and Enterobacteriaceae were highly sensitive to imipenem,meropenem and ertapenem.Resistant rate of Acinetobacter baumannii to imipenem and meropenem was 79.48% and 80.35% respectively,Pseudomonas aeruginosa had the lowest resistant rate to amikacin (10.70%). Gram-positive bacteria were highly sensitive to vancomycin and linezolid.Conclusion The major pathogens isolated from the elderly patients are gram-negative bacteria,and antimicrobial resistance is serious,surveillance of antimicrobial resist-ance is important for rational use of antimicrobial agents and control of pathogen resistance.
