急性白血病56例患者并发败血症血培养分析

Analysis of 56 cases of blood cultures from acute leukemia patients with septicemia

目的探讨急性白血病患者感染败血症病原菌的分布及对抗生素的敏感性。方法我院2003年1月至2005年12月从血液标本中分离的感染菌作回顾性分析。结果急性白血病患者血培养致病菌56株,并发真菌3株;G-杆菌占58.9%,其中超广谱β内酰胺酶阳性菌13株(39.4%),G+球菌占41.1%,其中耐甲氧西林葡萄球菌9株(39.1%)。G-杆菌对美洛培南,头孢匹美,哌拉西林/三唑巴坦,阿米卡星敏感,对青霉素类、单环β-内酰胺类以及头孢噻肟耐药率高,G+球菌对万古霉素敏感性最高,对其他抗生素大都耐药。结论抗生素滥用,导致超广谱β内酰胺酶以及耐甲氧西林葡萄球菌菌株增加是白血病患者细菌耐药率增高的主要原因,细菌培养及药敏实验对临床合理使用抗生素意义重大。

Objective To explore the drug sensitivity and bacterium species distribution of blood cultures from acute leukemia patients with nosocomial infections septicemia. Methods To retrospectively analyze the strains of pathogens separated from blood samples in Jan.2003, to Dec.2005 years in Northern Sichuan Medical College affiliated hospital. Results Among the 56 Strains of nosocomial infections septicemia, G-bacterium was the leading cause of infection （58.9%）, followed by G^＋ Coccus （41.1%）. There were 13 Strains of Extended Spectrum β-lactamase among the G^- bacterium （ 39.4%） and 9 Strains of methecillin resistance staphylococcus among G^＋ Coccus （39.1%）. G^- bacterium were sensitive to meropenem、Cefepime、Piperacillin/Tazobactam and Amikacin, resistant to penicillin、Monobactams and cefctaxime; G^＋ Coccus were most sensitive to Vancomycin, while has resistance to most of other antibiotic. Conclusion Increased Extended - Spectrum β-lactamase and methecillin resistance staphylococcus are one of the major risk of Drug resistance of acute leukemia with septicemia. Analysis on species distribution in bloodstream cultures or the drug sensitivity are very important to treat those nosocomial infections reasonably.