儿童急性白血病感染败血症病原菌分布及耐药性分析  

Acute leukemia in children with septicemia pathogenic bacteria distribution and drug resistance analysis

作　　者：郑竹美[1] 叶青[1] 李建平[1] 

机构地区：[1]浙江大学医学院附属儿童医院,浙江杭州310003

出　　处：《药物与人》2014年第10期355-356,共2页Medicine & People

摘　　要：目的：分析惠性白血病患儿感染败血症病原菌的分布和耐药性，以及血象特点，为治疗继发败血症提供临床依据。方法：对我院2012．1—2013．12血液科收治的急性白血病感染败血症患儿的血常规和血培养阳性茼株作回顾性分析。结果：163例急性白血病感染败血症患儿，外周血白细胞计数为（2．67±4．05）×109／L，血小板计数为（91．17±106．08）×109／L，中性粒细胞计数绝对值为（1．03±2．46）×109／L。血培养阳性致病菌222株，有41种菌，包括革兰阴·挂茼90株（40．54％），主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌，革兰阳性茼130株（58．55％），主要为表皮葡萄球菌、金黄色葡萄球菌、人葡萄球茼、缓疽链球菌，真菌2株（（0．90％），均为热带假丝酵母菌。革兰阳性菌对青霉素G、复方磺胺甲恶唑耐药率高，对万古霉素高度敏感。革兰阴性菌对氨苄西林耐药率高，对丁胺卡那霉素、舒普深耐药率低，对亚胺培南高度敏感。结论：急性白血病感染败血症病原菌种类分布宽，耐药率高，骨艇抑制时，尽旱做血培养度药物敏感试验，提倡合理用药。objective to analyze the acute leukemia children with septicemia distribution and drug resistance ot pathogenic bacteria, and less regresmon charactemstLc, provlaes the clinical basis for the treatment of secondary sepsis. Methods 2012.1 2013.12 in our hospital onset of acute leukemia with septicemia in children with blood routine and blood culture positive strains were retrospectively analyzed. Results 163 cases of children with acute leukemia with septicemia, peripheral blood leukocyte count for （2.67 ＋ 4.05）× 109 / L, the platelet count is （91.17 ＋ 106.08） × 109 / L, neutrophil count absolute value is （1.03 ＋ 2.46） × 109 / L. Blood culture positive for 222 strains pathogenic bacte- ria, 41 species of bacteria, including 90 strains of gram--negative bacteria （40.54 % ）, mainly for e. coli, klebsiella pneumoniae, pseudomonas aeruginosa, gram--positive bac- teria of 130 strains （58.55%）, mainly for the epidermis Staphylococcus aureus aureus, bacillus coli, staphylococcus aureus, streptococcus disease, fungal strains （0.90%）, are all tropical candida. Gram--positive bacteria to penicillin G, compound sulfamethoxazole resistant rate is high, is highly sensitive to vaneomyein, gram--negative bacteria to ampicillin resistant rate high, to amikacin, shope resistant rate is low, is highly sensitive to imine pei south. Conclusion acute leukemia with septicemia pathogenic bacteria species wide distribution, high resistance, bone marrow suppression, do blood cultures and drug sensitive test as soon as possible, promote the rational use of drugs.

关 键 词：儿童 急性白血病 败血症 耐药性 

分 类 号：R733.71[医药卫生—肿瘤]