老年恶性肿瘤患者CRE医院感染分布特点及耐药性分析  

Distribution and drug resistance of nosocomial infection in elderly patients with malignant tumors in CRE

作　　者：林臻[1] 黄倩 王萍[1] LIN Zhen;HUANG Qian;WANG Ping(Department of Hospital Infection Management,Cancer Hospital Affiliated to Guangxi Medical University,Guangxi Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院医院感染管理科

出　　处：《临床医药文献电子杂志》2019年第65期3-5,共3页Electronic Journal of Clinical Medical Literature

基　　金：广西壮族自治区卫计委课题(Z20170456)

摘　　要：目的分析老年恶性肿瘤患者耐碳青霉烯类肠杆菌科细菌(CRE)医院感染特点及其耐药性,为临床治疗与院感防控提供参考。方法选取2014年8月1日~2017年7月31日某省肿瘤治疗中心收治的发生肠杆菌医院感染的老年恶性肿瘤住院患者436例作为研究对象,将其分为观察组(CRE组,耐碳青霉烯类肠杆菌科细菌感染)与对照组(CSE组,碳青霉烯类抗菌药物敏感的肠杆菌科细菌感染),对数据进行统计分析。结果老年恶性肿瘤住院患者发生肠杆菌医院感染436例,其中CRE感染97例,发生率为22.25%;最常见的CRE是肺炎克雷伯菌、大肠埃希菌、奇异变形杆菌;CRE除对复方磺胺甲噁唑、四环素、头孢唑林及氨曲南较敏感外,对其他常用抗菌药物的耐药率均大于40%;436例患者中死亡26例,死亡率5.96%,而CRE组死亡率11.34%、CSE组死亡率4.42%,两组死亡率比较,差异有统计学意义(P<0.05)。结论老年恶性肿瘤患者CRE感染后病死率高,临床应加强对CRE菌株的监测,及时采集感染部位标本做病原学培养并根据药敏结果合理选择抗菌药物,贯彻落实多重耐药菌医院感染防控策略。Objective To analyze the characteristics and drug resistance of carbapenem-resistant Enterobacteriaceae(CRE)nosocomial infection in elderly patients with malignant tumors,and to provide reference for clinical treatment and nosocomial infection control.Methods The clinical data of elderly patients with Enterobacteriaceae nosocomial infection in a provincial cancer treatment center from August 1,2014 to July 31,2017 were retrospectively investigated.The patients with carbapenem-resistant Enterobacteriaceae bacterial infection were taken as the observation group(CRE group)and those with carbapenem-sensitive Enterobacteriaceae bacterial infection as the control group(CSE group).The data were collected with SPSS16.0 software.Statistical analysis was carried out.Results Enterobacter nosocomial infection occurred in 436 elderly patients with malignant tumors,97 of them were CRE infection,the incidence rate was 22.25%.The most common CRE was Klebsiella pneumoniae,Escherichia coli and Proteus mirabilis.CRE was sensitive to compound sulfamethoxazole,tetracycline,cefazolin and aztreonam,and its resistance rate to other commonly used antibiotics was more than 40%.The mortality rate was 5.96%in 26 cases,11.34%in CRE group and 4.42%in CSE group.There was a significant difference in mortality between the two groups(P<0.05).Conclusion The mortality of elderly patients with malignant tumors after CRE infection is high.Clinical surveillance of CRE strains should be strengthened.Pathogenic culture should be done in time to collect specimens from infected sites,and antibiotics should be selected reasonably according to the results of drug susceptibility.The strategy of prevention and control of nosocomial infection of multi-drug-resistant bacteria should be implemented.

关 键 词：肿瘤 碳青霉烯 肠杆菌科细菌 临床分布 耐药性 

分 类 号：R446.5[医药卫生—诊断学]