CAJ | 학술논문

目的：探讨医院重症监护病房（ICU）尿路感染常见病原菌的分布及其耐药特性，以便更好地为临床合理选用抗菌药物提供依据，指导临床合理用药。方法对2013年1月1日至2014年12月31日该院ICU收治的尿路感染患者尿液标本分离出的225株病原菌进行鉴定和药敏分析。结果225株病原菌中革兰阴性菌119株（52.9%），革兰阳性球菌35株（15.6%），真菌53株（23.6%），其他18株（8.0%）。革兰阳性球菌对万古霉素、利奈唑胺均敏感；革兰阴性菌对亚胺培南、美罗培南均敏感；真菌对两性霉素B、制霉菌素均敏感。产超广谱β-内酰胺酶（ESBLs）菌株以大肠埃希菌为主，检出率为47.7%（21/44）。结论革兰阴性菌为尿路感染的主要病原菌，对常用抗菌药物耐药率呈上升趋势，对指导临床合理使用抗菌药物、选择有效抗菌药物治疗具有重要意义。
목적：탐토의원중증감호병방（ICU）뇨로감염상견병원균적분포급기내약특성，이편경호지위림상합리선용항균약물제공의거，지도림상합리용약。방법대2013년1월1일지2014년12월31일해원ICU수치적뇨로감염환자뇨액표본분리출적225주병원균진행감정화약민분석。결과225주병원균중혁란음성균119주（52.9%），혁란양성구균35주（15.6%），진균53주（23.6%），기타18주（8.0%）。혁란양성구균대만고매소、리내서알균민감；혁란음성균대아알배남、미라배남균민감；진균대량성매소B、제매균소균민감。산초엄보β-내선알매（ESBLs）균주이대장애희균위주，검출솔위47.7%（21/44）。결론혁란음성균위뇨로감염적주요병원균，대상용항균약물내약솔정상승추세，대지도림상합리사용항균약물、선택유효항균약물치료구유중요의의。
Objective To investigate the distribution and drug resistance of common pathogenic bacteria in ICU patients with urinary tract infection so as to provide the basis for rationally selecting the antibacterial drugs in clinic and guiding the clini-cally rational drug use. Methods 225 strains of pathogenic bacteria isolated from the urine samples among ICU patient with uri-nary tract infection in our hospital from January 1, 2013 to December 31,2014 were performed the identification and drug suscep-tibility test. Results Among 225 strains of pathogenic bacteria,119 strains(52.9%) were Gram-negative bacteria,35 strains (15.6%)were Gram-positive bacteria,53 strains(23.6%) were fungi and 18 strains(8.0%) were other bacteria. Gram-positive bacte-ria were sensitive to both vancomycin(VA) and linezolid(LZD),Gram-negative bacteria were sensitive to both imipenem(IPM) and meropenem(MEM),and fungi were sensitive to amphotericin B(AMPHO) and nystatin(NYST). In ESBLs producing bacteria, Escherichia coli was predominant,its detection rate was 47.7%(21/44). Conclusion Gram-negative bacteria are the major pathogens in urinary tract infection and their resistance to commonly used antibacterial drugs shows the upward trend ,which has important significance to guide rational use of antibacterial drugs in clinic and select effective antibacterial drugs.