恶性肿瘤患者鲍曼不动杆菌感染的现患率调查及耐药性分析  

Survey on prevalence rate of Acinetobacter baumannii infection in malignant tumor patients and analysis of drug resistance

作　　者：肖美芳[1] 王昌富[1] 周义正[1] 邱小燕[1] 

机构地区：[1]华中科技大学附属荆州医院检验科,湖北荆州434020

出　　处：《检验医学与临床》2015年第19期2820-2822,共3页Laboratory Medicine and Clinic

基　　金：国家科技创新基金(国科发计[2013]583号)

摘　　要：目的探讨恶性肿瘤患者鲍曼不动杆菌感染的现患率及细菌耐药性,为临床预防和诊治提供参考。方法选取恶性肿瘤患者691例,取痰液、咽拭子、穿刺液及尿液作为标本检测鲍曼不动杆菌,并通过纸片扩散法行耐药性分析。结果 691例患者取不同部位标本1 355份,分离得到52株鲍曼不动杆菌,检出率为3.84%,感染率为7.53%。其中男性和女性患者现患率分别为7.80%和7.21%,差异无统计学意义(P>0.05)。≥60岁恶性肿瘤患者现患率为9.09%,<60岁患者为4.13%,差异有统计学意义(P<0.05)。肺癌、大肠癌患者鲍曼不动杆菌现患率分别为10.06%和9.12%,明显多于其他部位肿瘤患者。痰液标本鲍曼不动杆菌检出率为5.93%,明显多于其他类型标本(P<0.05)。52株鲍曼不动杆菌对头孢唑林耐药率达到100.00%,对头孢呋辛、头孢曲松和庆大霉素的耐药率也较高,分别为88.46%、82.69%和78.85%;对多黏菌素耐药率最低,仅1.92%,此外对美罗培南和亚胺培南的耐药性较低,分别为11.54%和17.31%。结论不同年龄、不同原发肿瘤的患者其鲍曼不动杆菌感染现患率存在差异。在临床工作中应减少患者的侵入性操作,并规范使用抗菌药物,根据药敏试验结果选择敏感药物,控制耐药菌株产生。Objective To study the prevalence rate of Acinetobacter baumannii infection in the patients with malignant tumor and the drug resistance to provide reference for clinical prevention and treatment .Methods 691 ca‐ses of malignant tumor were selected .Sputum ,pharynx swabs ,puncture fluid and urine were collected as specimens for detecting Acinetobacter baumannii ,and the drug resistance analysis was performed by using the disk diffusion method .Results 1 355 samples were taken from different parts in 691 patients ,52 strains of Acinetobacter bauman‐nii were isolated with the detection rate of 3 .84% and the infection rate of 7 .53% .The prevalence rates of males and females were 7 .80% and 7 .21% respectively ,the difference was not statistically significant（P 〉0 .05） .The preva‐lence rate in malignant tumor patients aged ≥ 60 years old was 9 .09% ,which in the patients aged 〈 60 years old was 4 .13% ,the difference was statistically significant （P 〈 0 .05） .The prevalence rates of Acinetobacter baumannii in lung cancer and colorectal cancer were 10 .06% and 9 .12% respectively ,which were significantly higher than those in other parts of tumor .The detection rate of Acinetobacter baumannii was 5 .93% in sputum specimens ,which was sig‐nificantly higher than that in the other specimens ,the difference was statistically significant（P〈 0 .05） .The resistant rate in 52 strains of Acinetobacter baumannii to cefazolin reached 100 .00% ,which to cefuroxime ,ceftriaxone and gentamicin were higher and were 88 .46% ,82 .69% and 78 .85% respectively ;the resistant rate to polymyxine was lowest ,only 1 .92% ,in addition ,the resistant rates to meropenem and imipenem were lower ,which were 11 .54% and 17 .31% respectively .Conclusion The prevalence rates of Acinetobacter baumannii exists in different ages and differ‐ent primary tumors .The the clinical work ,the invasive operations in the patients should be reduced .The antibacterial drugs should be normally used ,and the sensitive antibacteria

关 键 词：恶性肿瘤 鲍曼不动杆菌 耐药性 

分 类 号：R515[医药卫生—内科学]