CAJ | 학술논문

目的：分析近9年该院呼吸科病房病原菌的分布及耐药状况，为临床合理使用抗菌药物提供依据。方法对呼吸科2003年1月至2011年12月细菌培养和药敏试验的结果进行回顾性分析和统计。结果共分离出5714株病原菌，主要分布于痰液（90．1％）、粪便（4．2％）和尿液（3．6％）；其中革兰阴性菌2943株（51．5％），革兰阳性菌596株（10．4％），真菌2175株（38．1％）。分离菌株数居前6位的病原菌依次为白色念珠菌、铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌、热带念珠菌和大肠杆菌。鲍曼不动杆菌和白色念珠菌的分离率逐年增加，而大肠杆菌的分离率降低。鲍曼不动杆菌、铜绿假单胞菌对所有抗菌药物都具有较高的耐药性，但鲍曼不动杆菌的耐药率逐年增加，铜绿假单胞菌的耐药率却呈现一定波动性。肺炎克雷伯菌对亚胺培南和美洛培南灵敏度较高，对其他抗菌药物的灵敏度具有逐渐增加的趋势。白色念珠菌对两性霉素B的灵敏度几乎为100％，且对其他抗菌药物也具有较高的灵敏度。结论呼吸科常见病原菌耐药现象普遍存在，临床抗感染治疗中应重视病原学检查，开展病原菌耐药性监测，合理选用抗菌药物。
목적：분석근9년해원호흡과병방병원균적분포급내약상황，위림상합리사용항균약물제공의거。방법대호흡과2003년1월지2011년12월세균배양화약민시험적결과진행회고성분석화통계。결과공분리출5714주병원균，주요분포우담액（90．1％）、분편（4．2％）화뇨액（3．6％）；기중혁란음성균2943주（51．5％），혁란양성균596주（10．4％），진균2175주（38．1％）。분리균주수거전6위적병원균의차위백색념주균、동록가단포균、포만불동간균、폐염극뢰백균、열대념주균화대장간균。포만불동간균화백색념주균적분리솔축년증가，이대장간균적분리솔강저。포만불동간균、동록가단포균대소유항균약물도구유교고적내약성，단포만불동간균적내약솔축년증가，동록가단포균적내약솔각정현일정파동성。폐염극뢰백균대아알배남화미락배남령민도교고，대기타항균약물적령민도구유축점증가적추세。백색념주균대량성매소B적령민도궤호위100％，차대기타항균약물야구유교고적령민도。결론호흡과상견병원균내약현상보편존재，림상항감염치료중응중시병원학검사，개전병원균내약성감측，합리선용항균약물。
Objective To analyze the distribution and drug resistance situation of pathogens in the respiratory department during the recent 9 years to provide the basis for rational use of antibacterial drugs in clinic .Methods All pathogens isolated from the respiratory depeartment from January 2003 to December 2011 and the drug susceptibility test results were retrospectively and statistically analyzed .Results A total of 5 714 strains of pathogenic bacteria were isolated ,which mainly distributed in the sputum (90 .1% ) ,excrement (4 .2% ) and urine (3 .6% );among them ,2 943 strains (51 .5% ) were Gram‐negative bacteria ,596 strains (10 .4% ) were Gram‐positive bacteria and 2 175 strains (38 .1% ) were fungi .The top six of isolated bacteria were Candida albi‐cans ,Pseudomonas aeruginosa ,Acinetobacter baumannii ,Klebsiella pneumoniae ,Candida tropicalis and Escherichia coli .The isola‐tion rates of A .baumannii and C .albicans were increased year by year ,while the isolation rate of E .coli was decreased .A .baumannii and P .aeruginosa had a high resistant to all antibacterial drugs ,whereas the resistant rate of A .baumannii was increased year by year and that of P .aeruginosa showed some fluctuation .K .pneumoniae had a high susceptibility to imipenem and meropenem ,and the sensitivity to other antimicrobial agents had a gradually increasing tendency .The sensitive rate of C .albicans to amphotericin B was almost 100% ,and they had a high susceptible to other antifungal agents .Conclusion Drug resistance of the pathogens is com‐mon in the respiratory department .It is of importance to emphasize the pathologic examination ,carry out the surveillance of drug re‐sistance of pathogenic bacteria ,and use the antibacterial drugs rationally in clinical anti‐infective therapy .