肿瘤医院血流感染患者病原菌分布与耐药性分析  

Distribution and antibiotic resistance of bacteria isolated from bloodstream infections in Beijing cancer Hospital

作　　者：刘琳娟 张晨[1,2] 张青云[1,2] 徐国兵[1,2] 

机构地区：[1]北京大学肿瘤医院 [2]北京市肿瘤防治研究所检验科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中华医院感染学杂志》2015年第3期528-530,共3页Chinese Journal of Nosocomiology

基　　金：国家863计划基金资助项目(2012AA02A504)

摘　　要：目的了解肿瘤医院血流感染患者的病原菌分布及耐药性,为临床治疗选择合理的抗菌药物提供依据。方法采用BacT/Alert 3D全自动血培养仪对2010年1月-2013年12月4 796份血标本进行检测,对阳性血培养使用VITEK-2Compact全自动鉴定系统进行鉴定和药敏试验,使用WHONET5.6软件进行分析。结果 4 796份血液标本中共检出病原菌613株,检出率为12.3%,其中革兰阴性菌344株占56.2%、革兰阳性球菌211株占34.4%、厌氧菌32株占5.2%、真菌26株占4.2%,检出最多的病原菌分别为大肠埃希菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌,分别占19.1%、15.2%、12.1%;按疾病种类分,胃癌、肠道肿瘤和淋巴癌为前3位,分别占17.0%、16.2%和11.5%;未发现耐亚胺培南、厄他培南肠杆菌科细菌,未发现耐万古霉素和利奈唑胺葡萄球菌。结论肿瘤患者血培养临床分离菌对常用抗菌药物存在不同程度的耐药性,应合理使用抗菌药物,降低血流感染的病死率。OBJECTIVE To investigate the clinical distribution and drug resistance characteristics of pathogens for bloodstream infections in our cancer hospital, and give some advice on rational use the antibiotics. METHODS The 4796 specimens of blood culture were detected by BacT/Alert 3D automated blood cultures system, and positive isolates were identified and antimicrobial susceptibility was tested by VITEK 2-compact-automatic microbiology analysis system. The results were analyzed by WHONET5. 6 software. RESULTS From the 4796 blood samples received, 613 strains of pathogens were identified, accounting for 12.3%, including 344 gram-negative strains （56.1%）, 211 gram-positive strains （31.5%）, 32 anaerobic strains （5.2%）, 26 fungal strains （4.2%）. The most frequent isolates were Escherichia coli （19.1 M）, coagulase-negative Staphylococcus （15.2 %） and Klebsiel- la pneumonia （12.1M）. And 17.0% of positive strains were detected from gastric cancer patients, 16.2% from intestinal tract cancer patients and 11.5 % from lymphoma patients. No imipenem- and ertapenem-resistant Enter- obacteriaceae strains were found. And no vancomycin- and linezolid-resistant Staphylococcus strains were found. CONCLUSION The clinical isolates from blood culture were resistant to many antibiotics in cancer hospital, therefore clinicians should rationally use the antibiotics to reduce the death rate of bloodstream infections.

关 键 词：肿瘤 血流感染 血培养 病原菌 耐药率 

分 类 号：R181.34[医药卫生—流行病学]