恶性血液病患者血液感染病原菌的分布及耐药性探讨

Exploration of distribution and drug resistance of blood pathogens in patients with malignant blood diseases

目的:分析恶性血液病患者血培养中病原菌的构成及耐药情况,为临床合理用药提供参考。方法:对2009年1月-2011年1月我院血液内科送检的血培养标本,对培养出的所有细菌进行菌种鉴定及药敏分析。结果:共分离到78株病原菌,以革兰阴性杆菌为主,占57.69%。列前几位的细菌分别为大肠埃希菌(23.08%),肺炎克雷伯菌(15.38%),表皮葡萄球菌(12.82%),人葡萄球菌(11.54%)。革兰阴性杆菌对阿米卡星及碳青霉烯类抗菌药物有较好的敏感性;革兰阳性球菌对利福平及万古霉素的耐药率较低。结论:恶性血液病患者血液感染的病原菌以革兰阴性杆菌为主,且对多种抗菌药物的耐药率较高,临床应根据药敏试验结果合理选用抗菌药物。

Objective：To analyze the constituents and drug resistance of pathogens in blood culture of patients with malignant blood diseases,and provide reference for reasonable drug use in clinic.Methods： Blood culture specimens in blood medicine physician department of our hospital from January 2009 to January 2011 were collected for bacterial identification and drug sensitivity analysis.Results： 78 pathogen strains were isolated in total,with gram negative bacilli as the dominant bacteria（57.69%）.The top few bacteria were eschrichia coli（23.08%）,klebsiella pneumoniae（15.38%）,staphylococcus epidermidis（12.82%） and staphylococcus hominis（11.54%）.Gram negative bacilli was sensitivity to amikacin and carbapenem,and gram positive bacilli was low resistance to rifampicin and vancomycin.Conclusion： Gram negative bacilli was the main pathogen in blood infection of patients with malignant blood diseases,which had high drug resistance to multiple antibiotics,so clinicians should choose antibiotics in line with the drug sensitivity test.