恶性血液病患者鼻部感染的病原菌分布及耐药性分析  

Analysis of bacterial distribution and drug resistance in nasal infection among patients with hematological malignancies

作　　者：胡原[1] 蔡昌枰[1] 糜琛蓉[2] 忻云妹[3] 倪语星[3] 

机构地区：[1]上海交通大学医学院瑞金医院耳鼻喉科耳鼻咽喉科研究所,上海200025 [2]上海交通大学医学院瑞金医院院内感染控制办公室,上海200025 [3]瑞金医院检验科,上海200025

出　　处：《上海交通大学学报（医学版）》2007年第9期1078-1080,共3页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的了解恶性血液病患者鼻部感染的细菌分布及耐药性，以利于指导早期鼻部感染时的经验性抗菌治疗。方法选择2006年1～12月在该院治疗的60例患有不同程度鼻部感染的恶性血液病患者，取其鼻腔、鼻窦脓液进行细菌培养及药敏检查。结果60例脓液标本中细菌检出率是71．67％，其中真菌占37．25％，G^＋球菌占54．90％，G^-菌占7．84％。在G^＋球菌中，金黄色葡萄球菌占11．76％，凝固酶阴性葡萄球菌占29．22％。其中耐甲氧西林金黄色葡萄球菌的检出率是66．67％，耐甲氧西林凝固酶阴性葡萄球菌的检出率是95．00％。耐甲氧西林葡萄球菌的药敏结果显示对多种抗菌药物耐药，仅对万古霉素、利福平及呋西地酸敏感。结论作者针对恶性血液病患者的鼻部感染存在条件致病菌及耐药菌的感染率高的特点提出了治疗对策。Objective To survey the bacterial distribution and drug resistance in nasal infection among patients with hematological malignancies for the sake of empiric antimicrobial therapy. Methods A tatol of 60 patients with hematological malignancies suffered from nasal infection during January 2006 to December 2006 were selected to obtain the pus specimen for antibiotics susceptibility test. Results The total, positive rate was 71.67% for the 60 specimens, with 37.25% for fungus, 54.90% for G^＋ bacteria and 7.84% for G^- bacteria. Among the G^＋ bacteria, Staphylococcus aureus accounted for 11.76% , coagulase-negative Staphylococcus 29.22%. The detectable rate of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococcus strain was 66.67% and 95.00% , respectively. The antibiotics susceptibility test revealed that methicillin-resistant Staphylococcus aureus was multiresistant and only susceptible to vancomycin, rifampin and fusidin. Conclusion Considering the increased incidence of conditional pathogen and resistant bacteria in nasal infection among patients with hematological, malignancies, the authors have proposed corresponding treatment strategies.

关 键 词：恶性血液病 感染 病原菌 耐药性 

分 类 号：R733[医药卫生—肿瘤] R765[医药卫生—临床医学]