2006-2012年某肿瘤医院医院感染回顾性分析  

Retrospective analysis on healthcare-associated infection in a cancer hospital between 2006 and 2012

作　　者：付雪松[1] 曾惠敏[1] 张霁[1] 姚云峰[1] 张荔[1] 杨峰鑫 杜云霞[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所,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：《中国感染控制杂志》2015年第10期704-707,共4页Chinese Journal of Infection Control

摘　　要：目的了解肿瘤医院住院患者医院感染情况,为有效防治肿瘤患者医院感染和指导临床合理选用抗菌药物提供依据。方法对2006年8月—2012年7月某肿瘤医院发生医院感染的住院患者资料进行回顾性分析。结果该肿瘤医院住院患者的医院感染例次发病率为1.53%(2 060/134 389),各年度医院感染例次发病率整体呈下降趋势。医院感染部位以下呼吸道为主(957例,46.46%),其次为血液(322例,15.63%)和腹、盆腔(289例,14.03%)。医院感染主要病原菌为铜绿假单胞菌(350株,16.16%)、金黄色葡萄球菌(216株,9.97%)、肺炎克雷伯菌(212株,9.79%)、大肠埃希菌(209株,9.65%)和白假丝酵母菌(141株,6.51%)。肺炎克雷伯菌和大肠埃希菌等革兰阴性(G-)杆菌对碳青霉烯类和含β-内酰胺酶抑制剂的药物敏感率高。结论肿瘤患者医院感染部位以下呼吸道为主,主要病原菌为G-菌,经验性治疗时,推荐碳青霉烯类及含β-内酰胺酶抑制剂的药物。Objective To investigate healthcare-associated infection（HAI）in patients in a cancer hospital,provide reference for controlling HAI in cancer patients,and guide rational use of antimicrobial agents.Methods Clinical data of patients in a cancer hospital between August 2006 and July 2012 were analyzed retrospectively.Results The incidence of HAI case was 1.53%（2 060/134 389）,and annual incidence showed a downward trend.The main infection site was lower respiratory tract（46.46%,n=957）,followed by bloodstream（15.63%,n=322）,abdominal and pelvic（14.03%,n=289）.The main pathogens were Pseudomonas aeruginosa（16.16%,n=350）,Staphylococcus aureus（9.97%,n=216）,Klebsiella pneumoniae（9.79%,n=212）,Escherichia coli（9.65%,n=209）,and Candida albicans（6.51%,n=141）.Gram-negative bacilli,including Klebsiella pneumoniae and Escherichia coli,were sensitive to carbapenems andβ-lactamase inhibitors.Conclusion Lower respiratory tract is the major HAI site in patients with cancer,and gram-negative bacteria are the main pathogens.Carbapenems andβ-lactamase inhibitors are recommended for the empirical treatment of HAI in cancer patients.

关 键 词：肿瘤 患者 医院感染 病原菌 抗药性 微生物 抗菌药物 

分 类 号：R181.32[医药卫生—流行病学]