癌症患者医院感染病原菌菌谱及耐药性分析  

Pathogens Spectrum and Drug Resistance of Nosocomial Infection in Cancer Patients

作　　者：吴兴平[1] 张琳[1] 谭肖鹂[1] 刘晓敏[1] 何丽容[1] 

机构地区：[1]中山大学肿瘤防治中心检验科,广东广州510060

出　　处：《中华医院感染学杂志》2009年第20期2801-2803,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨癌症患者医院感染病原菌的分布及其耐药状况。方法回顾分析癌症患者医院感染1451例病例,采用WHONET-5软件进行统计处理。结果1451株病原菌中革兰阴性(G-)杆菌492株,占33.9%,革兰阳性(G+)球菌411株,占28.3%,真菌548株,占37.8%;痰标本955株中G-杆菌为25.5%,G+球菌为31.2%,真菌为43.3%;大便标本284株中检出G-杆菌为64.4%,G+球菌为10.2%,真菌为25.5%;血液72株中检出G-杆菌为62.5%,G+球菌为30.5%,真菌为7.0%;咽拭子140株中检出G-杆菌为15.0%,G+球菌为43.0%,真菌为42.0%;药敏试验结果提示,G-杆菌对亚胺培南高度敏感对一代、二代头孢菌素、氨苄西林、哌拉西林等有较高耐药性,G+球菌对万古霉素高度敏感,对苯唑西林、青霉素、红霉素等耐药率很高,真菌对唑类抗菌药呈明显耐药。结论由于产超广谱β-内酰胺酶菌(ESBLs)和耐甲氧西林葡萄球菌(MRS)检出率较高,临床用药应依据药敏试验结果选择和合理使用抗菌药物,控制病原菌的耐药性。OBJECTIVE To study the distribution and drug resistance of the cancer patient＇s pathogenic bacteria. METHODS The clinical nosocomial infection of 1451 cancer patients was analyzed by using the soft WHONET-5. RESULTS Of 955 strains isolated from sputa, the G^- bacilli were 31.2%, and their main bacteria were Pseudomonas aeruginosa and Klebsiell pneumoniae, the G^＋ coccis were 31.2 %, and their main bacteria were Staphylococcus epidermidis, and the fungi were 43.3%, and their main molds were Candida. albicans. Of 284 strains isolated form stool, the G^- bacilli were 64.4%, and their main bacteria were Eschericha coli, the G^＋ cocci were 10.2 % and their main bacteria were S. epidermidis, and fungi were 25.5 %. Of 72 strains isolated from blood, the G^- bacilli were 62.5 %, and their main bacteria were E. coli, the G^＋ cocci were 30.5% and the fungi were 7.0%. Of 140 strains isolated from pharyngeal swab, the G^- bacilli were 15.0%, and the G^＋ cocci were 43.0% and the fungi were 42.0%. The results of sensitivity tests showed as followed： The G^- bacilli had a highly sensitive to imipenem, and had a high drug resistance against the first and second generation cephalosporin, ampicillin, piperacillin. The G^＋ cocci were highly sensitive to vancomycin and had a high drug resistance against oxacillin, penicillin, and erythromycio, the fungi had an obvious drug resistance against azoles. CONCLUSIONS It is high prevalence of ESBLs among MRS, and Staphylococcus. The application and selection of antibiotics must be based on the results of sensitivity tests,and the drug resistance of pathogenic bacteria must be controlled.

关 键 词：癌症患者 医院感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]