血液科医院感染部位及病原菌分析

Pathogenic bacteria causing nosocomial infections in department of hematology and infection sites

目的了解血液病患者医院感染部位分布、病原菌特点及耐药性,为临床合理选择抗菌药物和医院感染的控制提供参考。方法对医院血液科2007-2010年住院患者临床分离的病原菌分布及耐药性进行分析。结果共分离到455株病原菌,医院感染以革兰阴性菌为主,占66.4%,大肠埃希菌为主要病原菌,占20.9%,感染部位以呼吸道、血流和尿路感染为主,痰培养中居首位的病原菌为鲍氏不动杆菌,血和尿培养中居首位的病原菌是大肠埃希菌,大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶的检出率分别为61.1%和38.3%,耐甲氧西林金黄色葡萄球菌和耐甲氧西林表皮葡萄球菌检出率分别为70.4%和86.8%。结论应针对医院感染高发部位及病原菌特点采取相应措施,以达到预防控制医院感染的目的。

OBJECTIVE To investigate the infection sites,distribution and drug resistance of the pathogens in hematology wards so as to provide laboratory evidence for controlling hospital infections and rationally selecting antibiotics in clinical practice.METHODS The distribution and the drug resistance of clinical isolates of pathogens from hospitalized patients in hematologic wards during 2007 to 2010 were analyzed.RESULTS Totally 455 strains of pathogens were isolated,gram-negative bacteria remained the predominant pathogens,accounting for 66.4%,Escheriahia coli was the most common pathogenic bacteria,accounting for 20.9%;the respiratory tract,bloodstream and urinary tract were the main infection sites;the primary pathogens isolated from sputum was Acinetobacter baumannii,and E.coli was predominant pathogen isolated from the blood and urine;the detection rates of extended spectrum β-lactamase-producing E.coli and Klebsiella pneumoniae were 61.1% and 38.3%,respectively,and the detection rates of methicillin-resistant Staphylococcus aureus and S.epidermidis were 70.4% and 86.8%,respectively.CONCLUSION It is necessary to take corresponding measures in accordance with high incidence of infection sites and the characteristics of the pathogens so as to prevent and control nosocomial infections.