摘要
目的探究肿瘤患者发生重症感染时,病原菌的分布及耐药性情况。方法对2014-2016年入住中山大学肿瘤防治中心重症医学科(ICU)的149名重症感染患者送检的病原学标本,分离培养的病原菌及药物敏感测定数据进行回顾性分析。结果 149名重症感染患者病原学送检标本共培养出271株病原菌,其中革兰阴性菌137株,占50.55%;革兰阳性菌91株,占33.58%;真菌43株,占15.87%;革兰阴性菌以铜绿假单胞菌、嗜麦芽寡养单胞菌和大肠埃希菌为主;革兰阳性菌主要以表皮葡萄球菌和缓症链球菌为主。葡萄球菌属对青霉素、红霉素、阿奇霉素、克拉霉素、环丙沙星等常用抗生药物的耐药率较高,达到并超过60%,铜绿假单胞菌对氨苄西林/舒巴坦、磺胺甲噁唑/甲氧苄啶、呋喃妥因等耐药率高,达90%以上,对亚胺培南的耐药率为31.3%,而对氟喹诺酮类药物如环丙沙星、左氧氟沙星及哌拉西林/他唑巴坦的敏感性相对较高。结论对于合并重症感染的肿瘤患者,应依据病情、耐药性选择较为敏感、广谱抗菌药物进行联合治疗。
OBJECTIVE To explore the distribution and drug resistance of pathogens isolated from the tumor patients with severe infections.METHODS A total of 149 patients with severe infections who were treated in intensive care unit（ICU）of Sun Yat-sen University Cancer Center from 2014 to 2016 were enrolled in the study,the specimens that were collected from the patients were submitted for culture of pathogens,and the data of drug susceptibility testing for the isolated pathogens were retrospectively analyzed.RESULTS Totally 271 strains of pathogens were isolated from the submitted specimens of the 149 patients with severe infections,of which 137（50.55% ）were gram-negative bacteria,91（33.58% ）were gram-positive bacteria,and 43（15.87% ）were fungi.The gramnegative bacteria were dominated by Pseudomonas aeruginosa,Stenotrophomonas maltophilia and Escherichia coli;the gram-positive bacteria were dominated by Staphylococcus epidermidis and Streptococcus mitis.The drug resistance rates of the Staphylococcus spp to the commonly used antibiotics such as penicillin,erythromycin,azithromycin,clarithromycin and ciprofloxacin were no less than 60% ;the drug resistance rates of the P.aeruginosa strains to ampicillin-sulbactam,sulfamethoxazole-trimethoprim and nitrofurantoin were more than 90% ,however,the strains were highly susceptible to the fluoroquinolones such as ciprofloxacin,levofloxacin and piperacillintazobactam.CONCLUSION As for the tumor patients complicated with severe infection,it is necessary to choose sensitive,broad-spectrum antibiotics for combination therapy according to the illness condition and drug resistance.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第18期4139-4142,共4页
Chinese Journal of Nosocomiology
基金
国家卫生计生委专项基金资助项目(1311200006402)
关键词
肿瘤
重症感染
病原菌
Tumor
Severe infection
Pathogen
