674株肿瘤患者多重耐药菌感染菌群分布与耐药性分析  

Distribution and Drug Resistance Analysis of 674 Strains of Multidrug-resistant Bacteria in Cancer Patients

作　　者：陈艳华[1] 江宗蔚[1] 舒宏[1] 刘金凤[1] 陆一平[1] CHEN Yan-hua;JIANG Zong-wei;SHU Hong;LIU Jin-feng;LU Yi-ping(Clinical Laboratory of Tumor Hospital Affiliated to Guangxi Medical University,Nanning City,Guangxi Zhuang Autonomous Region,530021,China)

机构地区：[1]广西医科大学附属肿瘤医院检验科,广西南宁530021

出　　处：《蛇志》2020年第3期310-314,共5页Journal of Snake

摘　　要：目的通过分析肿瘤患者多重耐药菌(MDRO)感染的分布特点及耐药性,为临床预防与控制MDRO感染及合理使用抗菌药物提供参考依据。方法采用回顾性研究分析的方式,收集2018年3月~2019年4月我院分离的MDRO数据,对MDRO感染部位、科室分布及病原菌的耐药特点进行分析。结果检出病原菌1942株,其中MDRO菌株674株,占34.71%。MDRO感染部位以血流感染为主(28.93%),其次是泌尿道(17.06%);检出科室居前3位依次为妇瘤外科(17.66%)、ICU(14.69%)、胃肠外科(12.91%)。检出的主要MDRO中,革兰阴性菌占74.93%,主要为产超广谱β-内酰胺酶大肠埃希菌(ESBLs-ECO);革兰阳性菌占25.07%,主要为耐甲氧西林的凝固酶阴性葡萄球菌(MASCN)。分离到的MDRO对多种抗菌药物具有较高的耐药性。结论肿瘤患者为MDRO感染的高危人群,MDRO对多种抗菌药物具有较高的耐药率;医院应做好MDRO的预防控制及感染性病原菌的耐药性检测,并根据药敏结果合理使用抗菌药物,以延缓多重耐药菌的产生。Objective To provide reference for clinical prevention and control of MDRO infection and rational use of antibiotics by analyzing the distribution characteristics and drug resistance of MDRO infection in cancer patients.Methods The data of MDRO isolated in our hospital from March 2018 to April 2019 were collected by retrospective study and analysis,and the infection site,department distribution and drug resistance characteristics of pathogenic bacteria of MDRO were analyzed.Results A total of 1942 pathogenic bacteria were detected,of which 674 were MDRO,accounting for 34.71%.The main site of MDRO infection was blood flow infection(28.93%),followed by urinary tract infection(17.06%).The top three departments were tumor surgery(17.66%),ICU(14.69%),and gastrointestinal surgery(12.91%).Among the main MDRO detected,Gram-negative bacteria accounted for 74.93%,mainly E.coli(ESBLs-ECO)producing extended spectrumβ-lactamase.Gram-positive bacteria accounted for 25.07%,mainly methicillin resistant coagulase negative staphylococcus(MASCN).MDRO isolated has high resistance to a variety of antimicrobials.Conclusion Tumor patients are the high risk group of MDRO infection while MDRO has a high resistance rate to a variety of antibiotics.Therefore,the prevention and control of MDRO and drug resistance test of infectious pathogens should be done well in hospital and antibiotics should be used rationally according to the drug sensitivity results so as to delay the production of multidrug-resistant bacteria.

关 键 词：肿瘤患者 多重耐药菌 分布特点 耐药性 

分 类 号：R73[医药卫生—肿瘤] R378[医药卫生—临床医学]