恶性肿瘤患者泌尿道感染菌群及其耐药分布

The Distribution and Drug Resistance of Pathogenic Microorganism in Malignancy Cancer Patients with Urinary Tract Infection

目的探讨恶性肿瘤患者泌尿道感染的病原微生物的分布及其耐药情况,为临床预防和控制尿路感染以及合理用药提供参考。方法对医院2007年至2009年恶性肿瘤患者尿标本分离的216株微生物按常规方法分离鉴定,药物敏感性试验采用K-B法。结果 216株病原菌中革兰阴性杆菌144株,占66.67%,主要是大肠埃希菌、变形杆菌、肺炎克雷伯菌、铜绿假单胞菌;革兰阳性球菌34株,占15.74%,主要是肠球菌和血浆凝固酶阴性的葡萄球菌;真菌38株,占17.59%,以白色念珠菌为主。药物敏感性试验表明,革兰阴性杆菌敏感率较高的药物是头孢哌酮舒巴坦、头孢他啶,革兰阳性球菌均敏感的药物是万古霉素。结论医院恶性肿瘤患者泌尿道感染的病原菌构成及其耐药性不断发生变化,临床应注重细菌耐药性的监测,合理选用抗菌药物。

Objective To survey the distribution of pathogenic microorganism in cancer patients with urinary tract infection,to supply reference in taking precautions against urinary infection and in rational use of drug.Methods Pathogenic microorganism were isolated in urine being collected from cancer patients with urinary tract infection,cultured and identified and drug sensitive test was done.Results A hundred and forty-four strains of Gram-negative aerobic bacteria were isolated（66.67%）,Escherichia coli,Proteus vulgaris,K.pneumoniae and Pseudomonas aeruginosa were more frequently isolated;34 strains of Gram-positive aerobic bacteria was isolated secondly（15.74%）,enterococcus and plasma-coagulase-negative Staphylococcus were more frequently isolated;38 strains of fungi were isolated and Candida albicans was mainly isolated.Result of drug sensitive tests showed that spectrum of Gram-negative aerobic bacteria were more sensitive to cefoperazone and ceftazidime,all of spectrum of Gram-positive aerobic bacteria were sensitive to vancomycin.Conclusion The distribution and drug tolerance of pathogenic microorganism in cancer patients with urinary tract infection was continua changed,the monitoring of drug tolerance of bacteria were very important.