恶性肿瘤患者医院感染的病原学及药物敏感性分析  

Analysis of Etiology and Drug Sensitivity in Nosocomial Infection in Patients with Malignant Tumors

作　　者：兰顺[1] 叶冬梅[1] 谢忠明[2] 

机构地区：[1]广西壮族自治区人民医院,南宁530021 [2]广西医科大学药学院,南宁530021

出　　处：《中国医院用药评价与分析》2012年第10期920-924,共5页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:分析恶性肿瘤患者医院感染的病原学及药物敏感性,为临床合理用药提供参考依据。方法:回顾性调查2010—2011年我院出现医院感染的98例恶性肿瘤患者的微生物病原学及药敏试验结果,并对病原学及药敏试验结果进行统计分析。结果:98例恶性肿瘤患者革兰阳性球菌检出率为19.2%(31/161),革兰阴性杆菌检出率为53.4%(86/161),真菌检出率为27.3%(44/161)。对常见革兰阴性杆菌敏感率均>70%的药物依次是亚胺培南、哌拉西林/他唑巴坦、阿米卡星、头孢哌酮/舒巴坦。金黄色葡萄球菌占革兰阳性球菌的45.2%(14/31),85.7%为甲氧西林敏感型;白色念珠菌占真菌的70.4%(31/44),对常用药物两性霉素B、制霉素、氟康唑、伊曲康唑敏感率>70%。结论:恶性肿瘤患者医院感染的致病菌以革兰阴性杆菌为主,其次为真菌,第三为革兰阳性球菌。革兰阴性杆菌对第2、3、4代头孢菌素及氟喹诺酮类呈现较高耐药性;真菌对常用抗真菌药具有较高敏感性;革兰阳性球菌(屎肠球菌除外)对常用药物亦保持较高敏感性。OBJECTIVE： To analyze the etiology and drug sensitivity in patients with malignant tumors and nosocomial infection for clinical reference of rational drug use.METHODS： In this retrospective survey,the etiology and antimicrobial susceptibility results for 98 malignant tumors inpatients with nosocomial infection from 2010 to 2011 were analyzed statistically.RESULTS： Of the 98 cases had detection rate of 19.2%（31/161） for gram-positive cocci,53.4%（86/161）for gram-negative bacilli,and 27.3（44/161） for fungi.The drugs with sensitivity rates of more than 70% to the common gram-negative bacilli included imipenem,piperacillin/tazobactam,amikacin,cefoperazone/sulbactam in turn.Staphylococcus aureus represented 45.2%（14/31） of the gram-positive coccus,and 85.7% of staphylococcus aureus were sensitive to methicillin.Candida albicans accounted for 70.4%（31/44） of all the fungus detected,and the sensitivity rates of candida albicans to amphotericin B,nysfungin,fluconazole and itraconazole were all higher than 70%.CONCLUSION： Gram-negative bacilli were the predominant pathogenic bacteria in nosocomial infection in patients with malignant tumor,followed by fungi and gram-positive cocci.Gram-negative bacilli were resistant to the second,the third and the fourth generations of cephalosporin and quinolones;fungi were sensitive to common antifungal agents,and gram-positive cocci（except enterococcus faecium） were also sensitive to common drugs.

关 键 词：恶性肿瘤患者 医院感染 病原学 药物敏感性 

分 类 号：R972[医药卫生—药品]