放化疗后肿瘤患者并发医院血流感染38例分析

Report of 38 cases of hospital-acquired bloodstream infection in patients with malignant tumor under radiotherapy and chemotherapy

目的 研究放化疗后肿瘤患者并发医院血流感染情况,为临床合理选用抗生素提供依据。方法 选取2001 年11月—2004年03月患恶性肿瘤并发医院血流感染者38例,对其血液中病原菌种类及药敏情况进行分析。结果 感染病原菌依次为大肠埃希菌、克雷伯菌属、表皮葡萄球菌、金黄色葡萄球菌及真菌等。革兰阴性菌及革兰阳性菌对青霉素及头孢菌素类均不同程度耐药。38例医院血流感染好转率55.3%,病死率39.5%。结论 放化疗后肿瘤患者医院血流感染病原菌主要为大肠埃希菌、克雷伯菌属、真菌及葡萄球菌等。其血流感染临床表现不典型,具有隐匿性特点。故对肿瘤放化疗患者应合理选用抗菌药物,重视血流细菌感染及细菌耐药性监测工作,提高抗菌药物合理使用水平。

Objective To investigate the clinical data of hospital acquired bloodstream infection in patients with malignant tumor undergoing radiotherapy and chemotherapy for the rational use of antibiotics.Methods The clinical data of 38 cases of hospital-acquired bloodstream infection in patients with malignant tumor from November 2001 to March 2004 were analyzed,including the distribution and susceptibility of pathogens isolated from bloodstream.Results The major pathogens isolated from blood were E.coli,Klebsiella spp.,S.epidermidis,S.aureus and fungi.Gram-negative and -positive isolates were variably resistant to penicillins and cephalosporin antibiotics.About 55.3% of the 38 patients improved clinically,and 39.5% died.Conclusions The pathogens causing bloodstream infection in tumor patients undergoing radiotherapy and chemotherapy were mainly E.coli,Klebsiella spp.,fungi and Staphylococcus spp.The clinical manifestations of bloodstream infection in such patients were atypical and insidious.Antibiotic should be rationally selected for patients undergoing radiotherapy and chemotherapy.Attention should be paid to antibiotic resistance surveillance in such patients.