血液科医院感染的临床分析  

Clinical analysis of nosocomial infections in patients of hematology department

作　　者：郝建萍[1] 朱震宏[2] 王蕾[1] 哈力达.亚森[1] 

机构地区：[1]新疆医科大学第一附属医院血液科,新疆乌鲁木齐830054 [2]新疆医科大学第一附属医院检验科,新疆乌鲁木齐830054

出　　处：《中华医院感染学杂志》2014年第9期2177-2179,共3页Chinese Journal of Nosocomiology

基　　金：新疆维吾尔自治区自然科学基金资助项目(201021100A45)

摘　　要：目的了解血液科与全院患者医院感染病原菌的分布及耐药率,指导临床合理使用抗菌药物。方法对2010年1-12月医院住院患者临床分离的病原菌分布及耐药率进行回顾性分析;采用SPSS16.0软件进行统计分析,计数资料采用率和构成比表示。结果血液科患者送检标本共分离病原菌157株,其中革兰阴性菌111株占70.7%,革兰阳性菌46株占29.3%,全院(除血液科外)共分离菌株3 842株,其中革兰阴性菌2837株占73.8%,革兰阳性菌1 005株占26.2%;血液科最常见革兰阴性菌为大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌,分别占22.9%、11.5%、10.8%,全院最常见革兰阴性菌为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌,分别占16.6%、14.0%、13.6%;大肠埃希菌、肺炎克雷伯菌和鲍氏不动杆菌对亚胺培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦较敏感;血液科大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶的检出率与全院相似,分别为55.6%和49.8%;耐甲氧西林金黄色葡萄球菌和耐甲氧西林表皮葡萄球菌检出率高于全院,分别为88.9%、90.0%,未检出耐万古霉素和替考拉宁葡萄球菌和肠球菌。结论医务人员应高度重视医院感染的预防控制,特别是血液病患者易发生医院感染,在原发病治疗过程中应采取各种措施减少感染发生,并根据病原菌的分布和耐药性,有针对性的使用抗菌药物,减少耐药性的发生。OBJECTIVE To investigate the distribution and drug resistance of pathogens causing nosocomial infection to patients in hematology department and in the whole hospital so as to guide rational use of antibiotics. METHODS The distribution and drug resistance of pathogens isolated from of the hospitalized patients from Jan 2010to Dec 2010were retrospectively analyzed.SPSS 16.0software was adopted for statistical analysis;rate and constituent ratio were adopted to express enumeration data.RESULTS A total of 157strains of pathogens were isolated from the specimens of patients in hematology department,with gram negative bacteria accounting for 70.7%（111strains）and gram positive bacteria accounting for 29.3%（46strains）;A total of 3842strains of pathogens were isolated from patients in the whole hospital（except for hematology department）,with gram negative bacteria accounting for 73.8%（2837trains）and gram positive bacteria accounting for 26.2%（1005strains）. The most common gram negative bacteria in hematology department were Escherichia coli,Klebsiella pneumonia, and Acinetobacter baumannii,accounting for 22.9%,11.5% and 10.8%;the most common gram negative bacteria in whole hospital were E.coli,K.pneumonia,and Pseudomonas aeruginosa,accounting for 16.6%, 14.0%and 13.6% respectively;E.coli,K.pneumonia,and A.baumannii were sensitive to imipenem,piperacillin/tazobactam,and cefoperazone/sulbactam;the detection rates of extended spectrum beta-lactamases（ESBLs）producing E.coli and K.pneumoniain hematology department were similarto that in the whole hospital,55.6%and 49.8%respectively.The detection rates of methicillin-resistant S.aureus and methicillin-resistant S.epidermidis in hematology department were higher than that of the whole hospital,88.9%and 90.0%respectively;Staphylococcus and Enterococcus that were resistant to vancomycin and teicoplanin were not detected. CONCLUSIONS Medical workers should pay high attention to the prevention and control of nosocomial infections, which often occurred to the

关 键 词：血液病 医院感染 病原菌 耐药性 

分 类 号：R181.32[医药卫生—流行病学]