CAJ | 학술논문

目的通过对我院内科ICU住院患者革兰阴性菌的分布及耐药性分析,以指导临床合理应用抗菌药物.方法回顾性分析我院2013年内科ICU住院患者送检标本检出病原菌的分布情况,应用ATB-Expression半自动微生物系统及配套进行菌株鉴定与药物敏感性测定,并用WHONET5.5软件进行数据统计分析. 结果我院2013年内科ICU住院患者送检标本中检出革兰阴性菌共759株,分别为鲍曼不动杆菌(33.3%)、铜绿假单胞菌(17.4%)、大肠埃希菌(16.7%)、肺炎克雷伯菌(10.8%)、肠球菌(7.7%)、凝固酶阴性葡萄球菌(6.9%)、阴沟肠杆菌(4.2%)及嗜麦芽窄食单胞菌(2.8%). 耐药性分析显示,鲍曼不动杆菌对头孢哌酮/舒巴坦耐药率最低(48.2%),对碳青霉烯类的耐药率高达90%以上;铜绿假单胞菌对磺胺甲噁唑耐药率最高(100%);大肠埃希菌对环丙沙星、左氧氟沙星、哌拉西林耐药率均达80%以上,但对碳青霉烯类保持较高的敏感性(100%);碳青霉烯类、阿米卡星和头孢哌酮/舒巴坦对肺炎克雷伯菌保持较强的抗菌活性.结论鲍曼不动杆菌的耐药性最为严峻,仅对头孢哌酮/舒巴坦相对敏感;阿米卡星、碳青霉烯类和头孢哌酮/舒巴坦对铜绿假单胞菌、大肠埃希菌及肺炎克雷伯菌保持有较强的抗菌活性.
목적 통과대아원내과ICU주원환자혁란음성균적분포급내약성분석,이지도림상합리응용항균약물.방법회고성분석아원2013년내과ICU주원환자송검표본검출병원균적분포정황,응용ATB-Expression반자동미생물계통급배투진행균주감정여약물민감성측정,병용WHONET5.5연건진행수거통계분석. 결과 아원2013년내과ICU주원환자송검표본중검출혁란음성균공759주,분별위포만불동간균(33.3%)、동록가단포균(17.4%)、대장애희균(16.7%)、폐염극뢰백균(10.8%)、장구균(7.7%)、응고매음성포도구균(6.9%)、음구장간균(4.2%)급기맥아착식단포균(2.8%). 내약성분석현시,포만불동간균대두포고동/서파탄내약솔최저(48.2%),대탄청매희류적내약솔고체90%이상;동록가단포균대광알갑오서내약솔최고(100%);대장애희균대배병사성、좌양불사성、고랍서림내약솔균체80%이상,단대탄청매희류보지교고적민감성(100%);탄청매희류、아미잡성화두포고동/서파탄대폐염극뢰백균보지교강적항균활성.결론 포만불동간균적내약성최위엄준,부대두포고동/서파탄상대민감;아미잡성、탄청매희류화두포고동/서파탄대동록가단포균、대장애희균급폐염극뢰백균보지유교강적항균활성.
Objective To analyze the distribution and drug resistance of gram-negative bacteria in internal medicine ICU, to guide clinical rational use of antibiotics. Methods Retrospectively analyzed the distribution of gram-negative bacteria in internal medicine ICU, and determined identification and drug sensitivity by ATB-Expression semi-automatic microbial sys-tem. All data were analyzed by WHONET 5.5 statistical software. Results 759 strains of gram-negative bacteria were detect-ed. There were Acinetobacterbaumannii (33.3%), Pseudomonas aeruginosa (17.4%), Escherichia coli (16.7%), Klebsiellap-neumoniae (10.8%), Enterococcus (7.7%), Coagulase negative staphylococcus (6.9%), Enterobacter cloacae (4.2%), and Stenotrophomonasmaltophilia bacteria (2.8%) respectively. Drug resistance analysis showed that Acinetobacterbaumannii resistant to cefoperazone/sulbactam was the lowest (48.2%), but the rate resisted to carbapenems was more than 90% to sulfamethoxa-zole, the drug resistant rate of Pseudomonas aeruginosa was 100%; the rate of Escherichia coli resisted to ciprofloxacin, lev-ofloxacin and piperacillin were above 80%, but maintained a higher susceptibility to carbapenems (100%). Carbapenems, amikacin and cefoperazone / sulbactam maintained strong antibacterial activity against Klebsiella , for the first choice of clinic. Conclusion The drug resistance of Acinetobacterbaumannii is the most severe , only cefoperazone/sulbactam is relatively sensi-tive to it. Amikacin, carbapenems and cefoperazone/sulbactam maintain strong antibacterial activity against Pseudomonas bacte-ria, Escherichia coli and Klebsiella pneumoniae.