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題名 | The Changing Patterns of the Incidence of Bacterial Nosocomial Infection and Antimicrobial Resistance at Far Eastern Memorial Hospital=亞東紀念醫院院內細菌感染菌種及抗藥性之改變傾向 |
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作者 | 蘇義仁; | 書刊名 | 醫學研究 |
卷期 | 9:2 1988.09[民77.09] |
頁次 | 頁119-130 |
分類號 | 414.83 |
關鍵詞 | 抗藥性; 改變; 亞東紀念醫院; 院內; 細菌感染; 菌種; 傾向; |
語文 | 英文(English) |
中文摘要 | 院內感染是每家醫院所面臨之重要課題。亞東紀念醫院把過去兩年所培養出來的嗜氧細菌,包括G(+)及G(-)的院內感染,以每半年為一階段,作分析比較菌種及抗藥性之改變傾向。菌種以Pseudomonas aeruginosa感染居首位(增加比率為88.3‰到132.6%);其次為Entenbacter cloaceae感染。感染部位發現以下呼吸道為最多,並且比率逐漸增加(23.9%→31.1%);這可能與重病患者增加、使用氣管插管、氣管造口術、及吸入性治療之機會增加有關。其它部位之感染以E. coli感染最常見,不過感染率逐漸減少,反而Enterobaeter cloaceae及Klebsiella pneumoniae的感染率上升。Amikacin是aminoglycoside類對上述幾種G(-)細菌感染最具敏感性,這也許因本院使用Amikacin的機會比cephalosporin少,以致藥產生抗藥性也少之故。第二代之cephalosporin對於Klebsiella pneumoniae (8%→17.2%)及Proteus mirabilis(14.7%)有很好的敏感性,對E. coli則較差。第三代之cephalosporin中之claforan及shiomarin對於Pleudomonas幾乎無效,只有Amikacin及colistin仍有很好之敏感性(分別約為8%及4%)。Piperacillin對Proteus mirabllis有高度敏感性,而對acinetobacter雖有些果效但抗藥性逐漸增加(14.3%→37.5%)。Staphyllococcus aureus對penicillin幾乎是100%的抗藥性,而cefazolin,clindamycin及oxacillin仍保持較好之敏感性,但仍免不了抗藥菌種的逐增。 |
英文摘要 | The incidence of bacterial nosocmial infection in the medical and surgical wards at Far Eastern Memorial Hospital in 1986 was compared to that in 1987. We obtained a result revealing that the incidence of nosocomial infection by Pseudomonas aeruginosa and Enterobacter cloaceae seemed to be increasing. The increase in infection mainly occurred in the lower respiratory tract contrasting that reported by other hospitals outside this country. We attribute the increase in lower respiratory tract infection to the increased frequency in endotracheal intubation or tracheostomy, this may reflect an iatrogenic cause of endotracheal tube-mainpulation-related contamination which calls for urgent reinforcement of meticulous aseptic technique in handling those indwelling tubes or catheters. Pseudomonas aeruginosa showed an increasing incidence of resistance to Cefoperazone and Colistin. While Gentamycin may not be satisfactory to combat nosocomial infection, Amikacin remains quite effective against these infection. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。