肿瘤患者血培养病原菌的分布及耐药性分析

Distribution and drug resistance of pathogens cultured from blood samples in cancer patient

目的了解癌症患者血培养病原菌的分布特点及其耐药情况,为临床诊疗提供依据。方法对2006～2009年血培养阳性的病原菌进行鉴定及药敏分析。结果 4405例血培养标本分离出病原菌385株,阳性率为8.7%,其中革兰阴性杆菌208株(54.0%),革兰阳性球菌109株(28.3%),真菌46株(12.0%),厌氧菌22株(5.7%)。革兰阴性杆菌对碳青霉烯类敏感性高,万古霉素和利奈唑胺对革兰阳性球菌作用效果较好,没有发现耐万古霉素的菌株,但有5.6%的肠球菌对万古霉素处于中介。结论肿瘤患者血培养的病原菌分布较广,以大肠埃希菌和凝固酶阴性的葡萄球菌(CNS)为主,耐药性严重,应加强对常用抗菌药物的耐药性监测。

Objective To understand the antibiotic resistance and distribution of pathogenic bacteria isolated from blood culture in cancer patient and to provide a basis for clinical diagnosis and treatment.Methods All the blood samples were collected from the patients between 2006 and 2009.Pathogenic bacteria were identified and the drug sensitivity test was performed.Results Total 385 pathogenic bacteria were isolated in 4 405 blood samples.The positive rate was 8.7%.Among them,109 strains of Gram negative bacteria were isolated and accounted for 28.3%.Fungi and anaerobe accounted for 12.0% and 5.7% respectively.The antibiotic resistance rate of Gram negative bacteria against carbapenem was in a higher level.The effect of vancomycin and linezolid to Gram positive bacteria was better.There were no strains resistant to vancomycin,but 5.6% of enterococci was in intermediate.Conclusion The pathogenic bacteria of blood culture in cancer patients spread widely.Escherichia coli and coagulase negative staphylococcus（CNS）are most frequent and the drug resistance is serious.More attention should be paid to monitor the bacterial resistance of frequently used drugs.