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題名 | 醫院特性與抗藥性型態=Hospital Characteristics and Antibiotic Resistance Patterns |
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作 者 | 葉梁蘭蘭; | 書刊名 | 院內感染控制雜誌 |
卷期 | 10:1 2000.02[民89.02] |
頁次 | 頁32-44 |
分類號 | 419.38 |
關鍵詞 | 醫院特性; 病原菌; 抗生素抗藥性; Hospital characteristic; Hospital pathogen; Antibiotic resistance; |
語文 | 中文(Chinese) |
中文摘要 | 這是一篇描述性報導,所整合的資料是來自(一)衛生署的44家醫院評鑑資料; (二)42家醫院提供的抗生素測敏統計; (三)44家醫院的檢體和菌株數量的調查問卷,這些數據依醫院的層級和地理位置各分成三組。與區域或地區醫院比較,醫學中心有較高佔床率、住院人次、手術人次和較多床數、醫師、醫檢師、檢體數和院內感染個案數,但是感控護理師與病床數相比卻較小。不論醫院的層級或地域所在,最頻繁的病原菌是Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae,Enter obacter cloacae,Acinetobacter spp.,Staphylococcus auresus,coagulase-negative staphylococcus,Enterococcus spp.,Proteus mirabilis,以及Serratia marcescens。其中Acinetobacter spp.的抗藥性最強且廣,且此菌對pipercillin,amikacin,和norfloxacin的抗藥性,在區域醫院都較醫學中心高;然而S. aureus對oxacillin抗藥性則在醫學中心最高。各家醫院施行的測敏試驗不一,因此將二十家以上醫院所測得的抗生素抗藥性與醫院特性做進一步地探討其間的相關性,最具一致性的關係是E. coli和K. pneumoniae對trimethoprim/sulfamethoxazole和cephalothin抗藥性與床數、手術人次、院內感染個案數和檢總數成正向關聯。這些結果顯示,若欲分析醫院潛在的抗生素抗藥性危險因子,必須進一歲配合各家醫院的臨床和藥物使用資料,做詳細研究與分析,方能確切地明瞭。 |
英文摘要 | The relationships of hospital characteristics and antibiotic resistance patterns have not been well documented in Taiwan. This descriptive report is based on the data collected from 3 sources: (1)characteristics of 44 hospitals from the Department of Health; (2)antibiograms from 42 hospitals; and (3)questionnaires on the quantity of specimens and isolates of the 44 hospitals. These data were then combined and stratified by 3 hospital types and by 3 hospital locations for analysis. Medical centers, compared with regional or local hospitals, had more beds, higher bed occupancy, and more in-patient visit, surgery visits, physicians, medical technologists, total specimens, and hospital acquired infection cases, but fewer infection control nurses compared to the number of beds. Regardless of the types or the locations of the hospitals, the most frequent pathogens were Escherichia coli, Pseudomonas aerugionosa, Klebsiella pneumoniae, Enterobacter cloacae, Acinetobacter spp., Staphylococcus aureus, coagulase-negative staphylococcus, Enterococcus spp., Proteus mirabilis, and Serratia marcescens. The broadest and strongest resistance was found in Acinetobacter spp. to piperacillin, amikacin, and norfloxacin; they were higher in the regional hospitals than those in the medical centers. In contrast, although it was not statistically significant, S. aureus had higher resistance to oxicillin in the medical centers than in the regional hospitals. Not every hospital applied the same panels for antimicrobial sensitivity tests, so the antibiotics tested in more than 20 hospitals were further studied for correlations. The most consistent findings were the positive relationships of the resistances of trimethoprim/sulfamethoxazole and cephalothin of E. coli and K. pneumoniase with hospital characteristics, including total beds, surgery visits, number of hospital acquired infection cases, and number of specimens. Further studies of these data with clinical and pharmacological information in detail at each hospital are greatly needed in the finding of under lined risk factors for antibiotic resistance in hospital. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。