血液肿瘤并发败血症143株病原菌分布及耐药分析

Pathogens and Their Drug Sensitivity Test of 143 Hematological Neoplasm Patients with Septicemia

目的探讨血液肿瘤患者并发败血症病原菌分布及对抗生素的敏感性。方法回顾分析2004-01/2006-12住院的血液肿瘤患者血培养标本中分离的病原菌。结果472份血培养标本检出致病菌143株,阳性率30.3%。革兰阴性菌95株(66.4%),以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌为主;革兰阳性菌40株(28.0%),以表皮葡萄球菌、金黄色葡萄球菌为主;真菌8株(5.6%)。革兰阴性杆菌除对亚胺培南、美洛培南的耐药率较低外,对其他抗菌药耐药性较高,铜绿假单胞菌对美洛培南也有一定耐药性。3种主要革兰阴性菌大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌对氨苄西林均高度耐药。革兰阳性球菌对万古霉素、替考拉宁耐药率低,尚未检出耐万古霉素菌株,部分肠球菌和溶血葡萄球菌株对替考拉宁耐药。结论血液肿瘤患者并发败血症的病原菌中,以革兰阴性菌为主;抗生素的大量使用,使革兰阴性菌和阳性菌的耐药率都增高,应根据细菌培养及药敏实验在临床中合理使用抗生素。

Objective To explore the pathogens isolated from blood cultures of with septicemia and their drug sensitivity. Method Retrospective analysis on haemological neoplasm patients pathogens separated from blood samples of studied patients from Jan. 2004 to Dec. 2006 was made. Result Among the 472 blood specimens, 143 strains of pathogen were identified,with a positive rate of 30. 3%. 95 strains of gram-negative bacteria including mainly Escherichia coli, Klebsiella pneumonia, Psudomonas aetuginosa constituted the leading cause of infection （66.4%）, and followed by 40 strains of gram-positive bacteria such as Staphylococcus epidermidis, Staphylococcus eureus （28.0%） and 8 strains of fungi（5.6% ）. Gram-negative bacteria were sensitive to imipenem and meropenem and resistant to other antibiotics. Gram-positive bacteria were highly sensitive to vancomycin but resistant to most of other antibiotics. Conclusion Gram-negative bacteria were the leading cause of infection. In order to treat these patients resonablly, bacterial culture and drug sensitivity test is necessary.