血液肿瘤患者感染病原菌分布与耐药性研究  

Distribution and drug resistance of pathogens of infections in patients with hematological malignancies

作　　者：袁海龙[1] 古力巴旦木.艾则孜 曹海洲[1] 曲建华[1] 段显琳[1] 江明[1] 

机构地区：[1]新疆医科大学第一附属医院血液病中心一病区,新疆乌鲁木齐830054

出　　处：《中华医院感染学杂志》2016年第4期812-814,共3页Chinese Journal of Nosocomiology

基　　金：新疆维吾尔自治区自然科学基金资助项目(2013211A100)

摘　　要：目的探讨血液肿瘤患者感染病原菌的分布及耐药性,为选择合适的抗菌药物提供依据。方法回顾性分析2009年7月-2012年7月医院1 249例血液肿瘤患者临床资料,对其血液样本的采集、培养的病原菌进行鉴定,并分析其病原菌的分布及耐药性。结果 1 249例患者血培养标本分离出病原菌127株,其中革兰阴性菌89株占66.9%,以大肠埃希菌34株26.8%、铜绿假单胞菌16株12.6%、肺炎克雷伯菌15株11.8%为主,革兰阳性菌36株占28.3%,以表皮葡萄球菌11株8.7%、金黄色葡萄球菌8株6.3%、屎肠球菌6株4.7%为主,真菌7株占4.8%,以热带假丝酵母菌4株3.2%为主;大肠埃希菌对亚胺培南的耐药率为100.0%,铜绿假单胞菌对阿米卡星的耐药率为93.8%,肺炎克雷伯菌对亚胺培南的耐药率为100.0%,表皮葡萄球菌、金黄色葡萄球菌对利奈唑胺、万古霉素、喹奴普汀/达福普汀的耐药率均为100.0%。结论血液肿瘤患者感染的病原菌种类较多、耐药率较高,做好病原菌耐药性及时监测和抗菌药物的正确选择,对控制血液感染起着非常重要的影响。OBJECTIVE To explore distribution and antibiotic resistance of infectious pathogens in patients with hematological malignances so as to provide reference for selection of suitable antibiotics.METHODS A retrospective analysis was conducted among 1 249 cases of hematological malignancies during Jul.2009 to Jun.2012.Their blood samples and cultured pathogens were identified and the distribution of pathogens and their drug resistance were analyzed.RESULTS Totally 127 pathogens were isolated from blood cultures of the 1 249 cases,including gram-negative bacteria（89strains,66.9%）dominated by Escherichia coli（34strains,26.8%）,Pseudomonas aeruginosa（16strains,12.6%）and Klebsiella pneumoniae（15strains,11.8%）,gram-positive bacteria（36strains,28.3%）dominated by Staphylococcus epidermidis（11strains,8.7%）,Staphylococcus aureus（8strains,6.3%）,Enterococcus faecium（6strains,4.7%）and fungi（7strains,4.8%）dominated by Candida tropicalis（4strains,3.2%）.The imipenem-resistance rate of E.coli and K.pneumoniae was 100.0%.The resistance rate of S.epidermidis and S.aureus was 100.0%to linezolid,vancomycin and quinupristin/dalfopristin.CONCLUSIONPathogens of infection are various with high resistance in patients with hematological malignances.Timely monitoring of pathogen resistance and correct selection of antimicrobial drugs is important for control of blood infections.

关 键 词：血液肿瘤 患者 感染 病原菌 耐药性 

分 类 号：R733.7[医药卫生—肿瘤]