摘要
目的:调查某院肿瘤患者多重耐药菌感染特点、病原菌分布及耐药性,为临床合理应用抗菌药物,预防和控制多重耐药菌感染提供参考依据。方法:对某院2014年收治肿瘤患者的多重耐药菌感染情况进行回顾性调查分析。结果:调查期间发生肿瘤患者多重耐药菌感染492例,占医院感染的10.87%,男女比例为1.83∶1,原发肿瘤肺癌居首。其中,62.81%的患者接受过手术,45.04%的患者接受过化疗,感染部位以呼吸道、手术切口和泌尿道为主。分离出革兰阴性菌426株,革兰阳性菌66株,超广谱β-内酰胺酶(ESBLs)菌株分离率为86.62%,耐甲氧西林葡萄球菌(MRS)检出率为91.38%。提示产ESBLs肠杆菌耐药严重,仅对阿米卡星及碳青霉烯类药物显示出较好的敏感性;鲍曼不动杆菌对头孢哌酮舒巴坦敏感率最高,为29.41%。未发现耐万古霉素葡萄球菌,但检出1例耐万古霉素屎肠球菌。结论:肿瘤患者是多重耐药菌感染的高发群体,且细菌耐药性较高,临床应予以重视,加强抗菌药物合理使用,积极控制病原菌的耐药性。
OBJECTIVE To investigate infectious status and drug resistance of multi-drug resistant bacteria among tumor patients to control resistant infections. METHODS Infectious data of tumor patients were reviewed from January to December 2014 in Tumor Hospital of Harbin Medical University. RESULTS Multi-drug resistant bacterial infection was identified in 492 tumor patients,and infection rate was 10. 87%. Among them,male / female ratio was 1. 83∶ 1,and most infections were pneumonia. A total of 426 strains of gram-negative bacillus and 66 strains of gram-positive coccus were isolated,the detection rate of extended-spectrum β-lactamases（ ESBLs） from gram-negative bacilli was 86. 62% and rate of methicillin-resistant staphylococcus aureus（ MRS） from gram-positive cocci was 91. 38%. ESBLs-producing Enterobacteriaceae strains were found more sensitive to amikacin and carbapenems compared with other antimicrobial agents,29. 41% of Acinetobacter baumannii strains were susceptible to cefoperazone-sulbactam. Resistance analysis showed no Staphylococcal strains but only 1 strain of Enterococcus Faecium resistant to vancomycin. CONCLUSION Multi-drug resistant bacterial infection is common in tumor patients,which should be paid more attentions to strengthen rational antibiotic use as far as possible.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2016年第5期398-402,共5页
Chinese Journal of Hospital Pharmacy
关键词
肿瘤患者
多重耐药菌
危险因素
耐药性
tumor patients
multi-drug resistant bacteria
risk factors
drug resistance
