肿瘤住院患者常见病原菌耐药性分析  

Drug resistance of common pathogens in hospitalized tumor patients

作　　者：胡少春[1] 童先丽[1] 杨妮珍[1] 雷旦生[1] 

机构地区：[1]湖北省肿瘤医院检验科,湖北武汉430079

出　　处：《中华医院感染学杂志》2013年第1期199-201,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解肿瘤患者住院期间常见病原菌的分布及耐药性,为临床合理用药提供参考。方法采用K-B纸片扩散法进行药敏试验,以WHONET5.4软件分析数据。结果 2008年10月-2010年10月肿瘤住院患者共分离出病原菌1300株,其中革兰阳性菌483株占37.2%,革兰阴性菌817株占62.8%;常见病原菌为大肠埃希菌372株,铜绿假单胞菌182株,肺炎克雷伯菌129株,金黄色葡萄球菌141株,表皮葡萄球菌70株,分别占28.6%、14.0%、9.9%、10.8%、5.4%;革兰阴性杆菌对亚胺培南、哌拉西林/他唑巴坦、头孢吡肟的耐药率均<30.0%,对其他抗菌药物的耐药率较高;革兰阳性球菌对青霉素和红霉素的耐药率均>70.0%,尚未发现耐万古霉素、利奈唑胺葡萄球菌。结论革兰阴性病原菌的分离率高于革兰阳性病原菌,以大肠埃希菌居多,对耐甲氧西林葡萄球菌(MRS)重症感染患者,糖肽类抗菌药物及利奈唑胺仍为治疗首选,对革兰阴性杆菌重症感染患者,亚胺培南仍为首选治疗药物。OBJECTIVE To know about the drug resistance and distribution of the common pathogenic bacteria in hospitalized tumor patients so as to provide basis for the clinical reasonable use of antibiotics. METHODS Disk diffusion method was used to determine the antimicrobial susceptibility. The data were analyzed by WHONET 5.4 software. RESULTS From Oct 2008 to Oct 2010, a total of 1300 strains of pathogens were isolated from hospital tumor patients, including 483 strains （37. 2%） of gram-positive bacteria and 817 strains （62. 8%） of gram- negative bacteria. Common pathogens included 372 strains of Escherichia coli, 182 strains of Pseudornonas aeruginosa, 129 strains of Klebsiella pneumoniae, 141 strains of Staphylococcus aureus, and 70 strains of S. epidermidis, accounting for 28.6%, 14.0%,9.9%, 10.8%, and 5.4%, respectively;the resistance rates of the isolated gram-negative bacteria to imipenem, piperacillin/tazobactam and cefepime were less than 30.0%. The resistance rates of the isolated gram-positive bacteria to penicillin and erythromycin were more than 70. 0%, there were no vancomycinor linezolidresistant Staphylococci strains detected. CONCLUSION The isolation rate of the gram-negative bacteria is higher than that of the gram-positive bacteria, and E. coli strains are the predominant isolates. Glycopeptides antibiotics and linezolid remains preferred for the patients with the severe methicillin-resistant Staphylococci infections, and imipenem is still selected as the first line drug for the infections caused by gram-negative bacilli.

关 键 词：肿瘤 住院患者 抗菌药物 耐药性 病原菌 

分 类 号：R378[医药卫生—病原生物学]