恶性血液病患者医院感染革兰阳性菌的变化  

Study of changes in gram-positive bacteria for nosocomial infections in patients with hematological malignancies

作　　者：何牧卿[1] 朱宝玲[1] 何牧群[2] 林晓骥[1] 郭文坚[1] 

机构地区：[1]温州医科大学附属第二医院血液肿瘤科,温州浙江325000 [2]福建省肿瘤医院肿瘤内科,福州福建350000

出　　处：《中华医院感染学杂志》2015年第8期1725-1727,共3页Chinese Journal of Nosocomiology

基　　金：福建省科技厅基金资助项目(2014-54011F);浙江省温州市科技局基金资助项目(Y20100301)

摘　　要：目的分析恶性血液病患者医院感染革兰阳性菌监测结果,指导预防和治疗感染的相关方案,以改善医疗质量及患者的预后。方法选取2009年6月-2013年5月医院收治的214例恶性血液病发生医院感染患者,对其送检标本进行病原菌检测及药敏试验,所有数据采用SPSS 13.0软件进行分析。结果 214例恶性血液病发生医院感染患者的感染部位以肺部为主,共114例占53.27%;检出病原菌中革兰阳性菌93株占43.46%,革兰阴性菌104株占48.60%,真菌17株占7.94%;人葡萄球菌及表皮葡萄球菌对青霉素耐药率较高,分别为68.0%及90.91%,对万古霉素耐药率均为0;大肠埃希菌对环丙沙星耐药率最高为43.40%,肺炎克雷伯菌及铜绿假单胞菌对头孢他啶的耐药率均最高,分别为36.84%及83.33%。结论恶性血液病患者在治疗期间感染率较高,而且部分感染病原菌有多药耐药性。OBJECTIVE To analyze the monitoring results of gram-positive bacteria for nosocomial infections in patients with hematological malignancies,guide relevant regimens for prevention and treatment so as to improve healthcare quality and patient prognosis.METHODS Totally 214 patients with hematological malignancies in our hospital from Jun.2009 to May 2013 were selected and received pathogen detection and drug sensitive test.And the statistical analysis of data was performed with the use of SPSS 13.0software.RESULTS The main infection sites of patients were lungs（114cases,53.27%）.The pathogens in patients were gram-positive bacteria（93strains,43.46%）,gram-negative bacteria（104strains,48.60%）and fungi（17strains,7.94%）.Drug sensitive test results showed that resistance rates of Staphylococcus hominis and Staphylococcus epidermidis to penicillin were 56.09% and 44.00% respectively,and their resistance to vancomycin was 0.Escherichia coli had the highest resistance of 43.40%to ciprofloxacin,Klebsiella pneumoniae and Pseudomonas aeruginosa had the highest resistance of 36.84% and 83.33% respectively to ceftazidime.CONCLUSION The patients with hematological malignancies have high infection rate during treatment and some infectious pathogens have multi-drug resistance.

关 键 词：恶性血液病 感染 革兰阳性菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]