感染性发热患者临床特点及其病原菌耐药性分析

Clinical Feature and Bacterial Resistance among Patients with Infectious Fever:An analysis

目的研究感染性发热患者的临床特点及其病原菌耐药情况。方法回顾性分析70例发热患者的临床特点,将病原菌株进行耐药性分析。结果从所送标本分离出致病菌70株,G+球菌40株(57.1%),其中金黄色葡萄球菌8株,凝固酶阴性葡萄球菌(CNS)32株;G-杆菌30株(42.9%),以沙门菌属及大肠埃希菌为主;药敏显示,53.1%的CNS对苯唑西林耐药,5株产ESBLs的菌株仅对碳青酶烯类及阿米卡星敏感。结论感染科病房多以G+球菌为主,产ESBLs的G-杆菌易致多重耐药,因此须合理选用抗菌药物,减少耐药菌株产生。

OBJECTIVE To study the clinical feature among patients with infectious fever and the antimicrobial resistance of infection pathogens. METHODS A retrospective analysis was carried out among 70 cases during recent 3 years. RESULTS The 70 strains of pathogens were isolated from blood and/or bone marrow cultures of 70 patients with infectious fever, 40 strains （57.1%） were Gram-positive cocci, in which 8 strains were Staphylococcus aureus, and 32 strains were coagulase negative staphylococci （CONS） ; 30 strains （42.9%） were Gram-negative bacilli,of which the Salmonella and Escherichia coli were the main microorganisms, 53. 1% of CONS were resistant to oxacillin. There were 5 strains of Gram-negative bacilli that were suspected to produce extended spectrum β-1actamases （ESBLs）, which were resistant to multiple antibiotics, the most active agent against these Gram-negative bacilli with ESBLs was imipenem. CONCLUSIONS The bacteria are mainly Gram- positive cocci for the patients with infectious fever in the infectious wards. The Gram-negative bacilli with ESBLs show more multi-drug resistance, we should rationally select antibiotics and decrease the occurrence of drug resistant strains.