恶性肿瘤患者医院肠杆菌科细菌感染及耐药性监测

Enterobacteriaceaeinfections in malignant tumor patients and monitoring of drug resistance

目的了解恶性肿瘤患者医院肠杆菌科感染现状及其耐药性,指导临床医师合理选择抗菌药物。方法对2010-2012年恶性肿瘤住院患者送检的872份标本中检出的肠杆菌科细菌分离鉴定及药敏试验结果进行分析。结果对医院两年内住院的恶性肿瘤患者的872份标本分离检出细菌442株,其中肠杆菌科细菌162株,占36.65%;占前3位的分别是大肠埃希菌、肺炎克雷伯菌和变形菌属,分别占25.93%、20.37%、19.75%;未发现对亚胺培南及美罗培南耐药的菌株;阿米卡星对大肠埃希菌、肺炎克雷伯菌和变形菌属的敏感率分别为100.0%、100.0%、96.9%;大肠埃希菌、肺炎克雷伯菌产ESBLs分别为42.9%、51.5%,对三代头孢菌素的耐药性较高。结论大肠埃希菌和肺炎克雷伯菌仍是恶性肿瘤医院感染肠杆菌科细菌的重要菌株,耐药性较强,临床应按照药敏结果合理选择抗菌药物。

OBJECTIVE METHODS To investigate the bacteria distribution and drug resistance of Enterobacteriace-ae isolated from patients with malignant tumor in the hospital so as to guide the reasonable use of antibiotics. RESULTS The identification of Enterobacteriaceae and the drug susceptibility testing for 872 specimens separated from patients with malignant tumor were retrospectively analyzed during 2010 to 2012. CONCLUSION The E. coli or K. pneumoniae are the predominant species of Enterobacteriaceae causing nosocomial infections in the patients with malignant tumor, and the strains are highly drug resistant. It is necessary to reasonably use antibiotics based on the result of drug susceptibility testing.