肿瘤患者医院感染革兰阴性杆菌的耐药性调查

Antimicrobial resistance of gram-negative bacilli causing nosocomial infections in tumor patients

目的探讨肿瘤患者革兰阴性杆菌(GNB)医院感染现状及耐药性,为临床医师合理用药提供参考依据。方法细菌培养严格按照《全国临床检验操作规程》进行;细菌鉴定采用法国生物梅里埃公司提供的API板条和软件系统;药敏试验采用K-B法,依据CLSI最新版本进行结果评价。结果从医院肿瘤患者感染性标本中共分离出168株GNB,大多数GNB均表现出多药耐药性;铜绿假单胞菌(PAE)和鲍氏不动杆菌(ABA)泛耐药菌株检出率分别为11.1%、18.7%;耐亚胺培南PAE和ABA菌株检出率分别为13.3%、18.7%。结论肿瘤患者医院感染GNB耐药性呈上升趋势,应采取综合性干预措施,遏制多药耐药菌医院感染。

OBJECTIVE To investigate antimicrobial resistance of gram-negative bacilli（GNB） causing nosocomial infections in tumor patients and provide reference for reasonable use of antibiotics.METHODS Bacterial culture was performed according to National Guide to Clinical Laboratory Procedures.The API kits and relative software（France,Merieux） were used to identify the bacteria.The drug susceptibility tests were performed by K-B method.The testing results were assessed according to the latest version of CLSI breakpoints.RESULTS Among 168 strains of GNB isolated from infective specimen,most of them showed multidrug resistance;the detection rates of pandrug-resistant Pseudomonas aeruginosa（PAE） and Acinetobacter baumanmii（ABA） were 11.1% and 18.7%,respectively;the isolation rates of imipenem-resistant PAE isolates and ABA isolates were 13.3% and 18.8%,respectively.CONCLUSION The antimicrobial resistance of GNB causing nosocomial infections in tumor patients shows an increasing tendency.The comprehensive intervention strategies should be adopted to prevent the nosocomial infections caused by multidrug-resistant bacteria.