急性白血病肺部感染病原菌分布情况及药敏研究  

Distribution and drug susceptibility of pathogenic bacteria in acute leukemia pulmonary infection

作　　者：饶洪梅 RAO Hongmei(Department of Hematology,Fuzhou First People's Hospital,Fuzhou 344000,Jiangxi,China)

机构地区：[1]抚州市第一人民医院血液科,江西抚州344000

出　　处：《中国现代医生》2023年第11期69-72,共4页China Modern Doctor

摘　　要：目的探究急性白血病肺部感染病原菌分布情况及药敏试验结果。方法选取2019年5月至2021年5月抚州市第一人民医院收治的急性白血病肺部感染患者156例作为研究对象,分别采集标本进行病原菌培养和药敏试验,并分析病原菌分布情况和药敏试验结果。结果156例患者共检出病原菌204株,其中革兰氏阴性菌120例,占58.82%,主要包括大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、阴沟肠杆菌、奇异变形杆菌,分别占所有菌株的25.64%、19.23%、11.54%、5.13%、6.67%、8.97%;革兰氏阳性菌62例,占30.39%,主要包括肺炎链球菌、表皮葡萄球菌、金黄色葡萄球菌、溶血葡萄球菌,分别占所有菌株的7.69%、8.97%、19.23%、3.85%;真菌22例,占10.78%,主要包括白色假丝酵母菌、光滑假丝酵母菌,分别占所有菌株的6.41%、7.69%。革兰氏阴性菌对头孢曲松、头孢哌酮、头孢呋辛、头孢唑林、哌拉西林、氨曲南、氨苄西林、左氧氟沙星、环丙沙星、阿米卡星、庆大霉素、妥布霉素、四环素、厄他培南、美罗培南、亚胺培南的耐药性分别为39.17%、0、38.33%、38.33%、37.50%、39.17%、35.00%、29.17%、30.00%、25.83%、1.67%、3.33%、25.00%、0.83%、1.67%、0。革兰氏阳性菌对青霉素G、红霉素、庆大霉素、克林霉素、环丙沙星、左氧氟沙星、四环素、利福平、普加环素、利奈唑胺、万古霉素、替考拉宁的耐药性分别为6.45%、16.13%、40.32%、17.74%、37.10%、12.90%、20.97%、35.48%、3.23%、1.61%、24.19%、0。真菌对两性霉素B、伊曲康唑、制霉菌素、氟康唑的耐药性分别为4.55%、9.09%、0、13.64%。结论革兰氏阴性菌是导致急性白血病患者引发肺部感染的主要病原菌,该类病原菌对亚胺培南、头孢哌酮等药物耐药性较低,临床只有针对性给予急性白血病肺部感染患者耐药性较低的抗生素治疗,才能进一步提高患者的临床治疗效果Objective To study the distribution and drug susceptibility test results of pathogenic bacteria in acute leukemia pulmonary infection.Methods A total of 156 patients with acute leukemia pulmonary infection admitted to Fuzhou First People's Hospital from May 2019 to May 2021 were selected as the study subjects.Specimens were collected for pathogen culture and drug sensitivity test,and the distribution of pathogen bacteria and drug sensitivity test results were analyzed.Results A total of 204 strains of pathogenic bacteria were detected in 156 patients,of which Gram-negative bacteria were present in 120 cases,accounted for 58.82%,mainly including Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii,Enterobacter cloacae and Proteus mirabilis,accounted for 25.64%,19.23%,11.54%,5.13%,6.67% and 8.97% of all strains respectively.Gram-positive bacteria were present in 62 cases,accounted for 30.39%,mainly including Streptococcus pneumoniae,Staphylococcus epidermidis,Staphylococcus aureus and Staphylococcus haemolyticus,accounted for 7.69%,8.97%,19.23% and 3.85% of all strains respectively.Fungi were present in 22 cases,accounted for 10.78%,mainly including Candida albicans and Candida smooth,accounted for 6.41%and 7.69% of all strains respectively.The resistance of gram-negative bacteria to ceftriaxone,cefoperazone,cefuroxime,cefazolin,piperacillin,aztreonam,ampicillin,levofloxacin,ciprofloxacin,amikacin,gentamicin,tobramycin,tetracycline,ertapenem,meropenem,and imipenem was 39.17%,0,38.33%,38.33%,37.50%,39.17%,35.00%,29.17%,30.00%,25.83%,1.67%,3.33%,25.00%,0.83%,1.67%,0.The resistance of gram-positive bacteria to penicillin G,erythromycin,gentamicin,clindamycin,ciprofloxacin,levofloxacin,tetracycline,rifampicin,procycline,linezolid,vancomycin and teicoplanin was 6.45%,16.13%,40.32%,17.74%,37.10%,12.90%,20.97%,35.48%,3.23%,1.61%,24.19% and 0 respectively.The resistance of fungi to amphotericin B,itraconazole,nystatin and fluconazole was 4.55%,9.09%,0 and 13.64%respectively.Conclusion Gram-

关 键 词：急性白血病 肺部感染 病原菌分布情况 药敏试验 

分 类 号：R733.71[医药卫生—肿瘤]