血液病患者分离的1153株病原菌耐药性分析  

Drug resistance analysis of 1 153 pathogenic bacteria isolated from patients with hematological diseases

作　　者：张伟 刘华 王微微 陆文英 周成 胡丽庆[5] 商安全 ZHANG Wei;LIU Hua;WANG Wei-wei;LU Wen-ying;ZHOU Cheng;HU Li-qing;SHANG An-quan(Department of Laboratory,The Fifth people Hospital of Jiaozuo City, Jiaozuo,Henan 454000,China)

机构地区：[1]焦作市第五人民医院检验科,河南焦作454000 [2]焦作市人民医院肿瘤内科,河南焦作454000 [3]盐城市第六人民医院检验科,江苏盐城224005 [4]复旦大学附属华山医院检验科,上海200040 [5]宁波市第一医院检验科,浙江宁波315010 [6]同济大学附属同济医院检验科,上海200065

出　　处：《现代预防医学》2019年第15期2816-2819,共4页Modern Preventive Medicine

基　　金：国家自然科学基金(81802084);浙江省医药卫生科技项目(2019332560);焦作市医学科研项目(2017KY057);盐城市医学科技发展计划项目(YK2016074、YK2017120、YK2017121);盐城市重点专科建设项目、盐城市创新团队建设项目

摘　　要：目的分析5家医院血液病患者细菌感染病原菌分布及药物耐药性,为临床治疗提供参考。方法对5家医院1年间血液病患者所分离病原菌及药敏结果进行分析总结。结果 1 153株病原菌主要来源于痰液(40.5%),其次为血液(30.2%)与中段尿(10.4%);G^+菌占33.5%,G^-菌占62.8%,真菌占3.7%。G^+球菌分离率在前4的为金黄色葡萄球菌(7.1%)、人葡萄球菌(6.5%)、粪肠球菌(5.7%)、屎肠球菌(4.2%)。G^-杆菌分离率在前4的为大肠埃希菌(15.5%)、肺炎克雷伯菌(14.8%)、铜绿假单胞菌(12.4%)、鲍曼不动杆菌(10.2%)。葡萄球菌对万古霉素、利奈唑胺敏感性为100%。肠球菌对万古霉素、利奈唑胺耐药率低于2%。大肠埃希菌与肺炎克雷伯菌对碳青霉烯类、米诺环素耐药率低于6%。铜绿假单胞菌对哌拉西林/他唑巴坦、阿米卡星耐药率低于10%。鲍曼不动杆菌对米诺环素耐药率为6.8%。结论临床需依据血液病患者的特点及药敏试验合理选择抗生素,减少耐药菌产生。Objective To analyze the distribution and drug resistance of pathogenic bacteria in patients with hematological diseases in five hospitals,so as to provide a reference for clinical treatment.Methods Pathogenic bacteria isolated from patients with hematological diseases in five hospitals in one year and drug sensitivity results were analyzed and summarized.Results 1 153 strains of pathogenic bacteria mainly originated from sputum(40.5%),followed by blood(30.2%)and midstream urine(10.4).G^+ bacteria accounted for 33.5%,G^- bacteria 62.8%,fungi 3.7%.The top four isolates of G+ cocci were Staphylococcus aureus(7.1%),Staphylococcus hominis(6.5%),Enterococcus faecalis(5.7%),Enterococcus faecium(4.2%).The top four isolates of G^- bacilli were Escherichia coli(15.5%),Klebsiella pneumoniae(14.8%),Pseudomonas aeruginosa(12.4%)and Acinetobacter baumannii(10.2%).The sensitivity of staphylococcus to vancomycin and linezolid was 100%.The resistance rate of enterococcus to vancomycin and linezolid was less than 2%.The resistance rates of Escherichia coli and Klebsiella pneumoniae to carbapenems and minocycline were less than 6%.The resistance rate of Pseudomonas aeruginosa to piperacillin/tazobactam and amikacin was less than 10%.The drug resistance rate of Acinetobacter baumannii to minocycline was 6.8%.Conclusion It is necessary to select antibiotics reasonably according to the characteristics of patients with hematological diseases and drug sensitivity tests in the clinic to reduce the occurrence of drug-resistant bacteria.

关 键 词：多中心 血液病 病原菌分布 耐药性 

分 类 号：R115[医药卫生—公共卫生与预防医学]