肿瘤患者医院感染病原菌分布及耐药性分析  

Distribution and antimicrobial resistance of pathogenic bacteria causing nosocomial infections in tumor patients

作　　者：王军[1] 余清源 刘华[1] 瞿秀[1] 

机构地区：[1]利川市人民医院检验科,湖北利川445400

出　　处：《中华医院感染学杂志》2014年第16期3936-3938,共3页Chinese Journal of Nosocomiology

基　　金：湖北省卫生厅基金资助项目(WJ01564)

摘　　要：目的了解山区医院肿瘤患者继发医院感染的临床特点、病原菌分布及耐药性,为有效治疗医院感染提供合理用药的实验室参考依据。方法调查2009年1月-2012年12月发生医院感染的226例肿瘤患者临床资料;标本留取、病原菌培养与鉴定均严格按照卫生部规定的临床微生物学检验的操作规范进行;药敏试验采用CLSI制定的K-B法,抑菌圈直径的测量,敏感、中介、耐药的划分依照CLSI最新折点标准,数据处理采用WHONET 5.5软件分析。结果 226例患者医院感染的主要部位是下呼吸道和泌尿道感染等,共培养出261株病原菌,其主要病原菌为铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、大肠埃希菌、鲍氏不动杆菌,分别占22.6%、16.5%、13.4%、10.7%、9.6%;耐亚胺培南铜绿假单胞菌和鲍氏不动杆菌检出率分别为16.9%、20.0%。结论干预和控制医院感染是成功救治肿瘤患者的关键,建议临床医师减少有创性医疗行为,合理应用抗菌药物,以改变病原菌耐药性快速增长的不良状态,提高肿瘤患者的临床治愈率。OBJECTIVE To understand clinical characteristics,distribution and antimicrobial resistance of pathogenic bacteria causing nosocomial infections in tumor patients in the mountain hospital and offer a reference for clinical anti-infective treatment.METHODS The clinical records were reviewed for 226 tumor patients with nosocomial infections.Infective specimens were collected for bacterial culture and identification by the routine microbiological methods.The susceptibility test was performed by K-B method recommended by CLSI.Measurement of diameter of inhibitor zones and classification of susceptibility,intermediate and resistance were done according to the newest breakpoints of CLSI.The WHONET 5.5software was used to process the data.RESULTS The main sites of nosocomial infections were lower respiratory tract and urinary tract.Totally 261 pathogenic bacteria were isolated from 226 infective specimens.Pathogenic bacteria mainly included Pseudomonas aeruginosa（22.6%）,Klebsiella pneumoniae（16.5%）,Staphylococcus aureus（13.4%）,E.coli（10.7%）and Acinetobacter baumannii（9.6%）.Susceptibility testing indicated that the above pathogens were multi-resistant to commonly used antibiotics.Imipenem-resistant P.aeruginosa and A.baumannii accounted for 16.9% and 20.0%,respectively.CONCLUSION It was critical to interfere and control nosocomial infections to treat tumor patients successfully.It was suggested that the clinician should reduce invasive medical procedures and apply the antibiotics reasonably in order to change the adverse tendency of the rapid growth of bacterial resistance and increase the clinical cure rate.

关 键 词：肿瘤患者 医院感染 易感部位 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]