胃肠肿瘤外科病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens in gastrointestinal tumor surgery department

作　　者：杜云霞[1] 姚云峰[1] 付雪松[1] 曾慧敏[1] 张霁[1] 

机构地区：[1]北京大学肿瘤医院医院感染管理科,北京100142

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第3期62-65,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：国家自然科学青年基金(No.81101879)

摘　　要：目的调查分析胃肠肿瘤外科病房病原菌分布及耐药情况,为指导临床合理用药提供依据。方法收集2013年1月至2013年12月北京大学肿瘤医院胃肠肿瘤外科病房送检的腹水、引流液、血液、痰、尿和中心静脉导管进行病原菌培养及耐药性分析。结果共检出病原菌94株,其中革兰阳性菌17株,革兰阴性菌71株,真菌6株。革兰阳性菌以金黄色葡萄球菌比例最高,为6株(6.4%),其中耐甲氧西林金黄色葡萄球菌(MRSA)4株(66.7%),未发现对万古霉素、替考拉宁和利奈唑胺耐药菌株;革兰阴性菌以大肠埃希菌比例最高,为25株(26.6%),其中产超广谱β-内酰胺酶(ESBL)大肠埃希菌21株(84.0%),对β-内酰胺类抗菌药物、氨曲南、喹诺酮类抗菌药物和氨基糖苷类抗菌药物等有较高耐药性。结论本院胃肠肿瘤外科病原菌以革兰阴性菌为主,耐药比较明显。Objective To analyze the distribution and drug resistance of pathogens in gastrointestinal tumor surgery department, and to provide guidance for reasonable clinical use of antibiotics. Methods Pathogens collected in ascites, drain, blood, sputum, urine and central venous catheters from patients in Gastrointestinal Tumor Surgery, Peking University Cancer Hospital ＆ Institute, during January 2013 to December 2013. Results Total of 94 strains of pathogens were isolated, including 17 strains of Gram positive bacteria, 71 strains of Gram negative bacteria and 6 strains of fungi. The most common isolate in Gram positive bacteria was Staphylococcus aureus （6 strains, 6.4%）, 4 strains of which were methicillin- resistant. No Staphylococcus aureus was resistant to vancomycin, teicoplanin or linezolid. The most common isolate in Gram negative bacteria was Escherichia coli （25 strains, 26.6%）, 21 strains of which were extended- spectrum beta-lactamase （ESBL） positive. Escherichia coli was highly resistant to I%lactam antibiotics, aztreonam, 4-quinolones and aminoglycosides. Conclusions Gram negative bacteria is the predominant pathogen in gastrointestinal tumor surgery department and highly drug-resistant.

关 键 词：胃肠肿瘤 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]