肿瘤患者医院感染革兰阴性杆菌的分布及耐药性分析

Distribution and drug resistance of gram-negative bacilli causing nosocomial infections in tumor patients

目的探讨肿瘤患者在医院感染中革兰阴性杆菌的分布及耐药性,为临床医师合理用药提供参考。方法细菌分离鉴定按照《全国临床检验操作规程》,采用K-B法进行药敏试验。结果肿瘤患者医院感染的高发部位主要为下呼吸道,占72.5%,其次为泌尿道、分泌物、血液及其他部位,分别占16.0%、5.6%、3.3%、2.6%;共分离出革兰阴性菌269株,排名前4位的革兰阴性菌依次为铜绿假单胞菌、大肠埃希菌、产气肠杆菌、肺炎克雷伯菌,分别占22.7%、21.9%、17.8%、12.6%;主要革兰阴性菌对常用抗菌药物均产生了一定的耐药性,仅对亚胺培南、美罗培南的耐药率较低,耐药率<16.0%。结论应加强病原菌的耐药性监测,以指导临床合理用药,减少多药耐药菌产生,降低医院感染率。

OBJECTIVE To explore the distribution and the drug resistance of the gram-negative bacilli causing nosocomial infections in tumor patients so as to guide the reasonable clinical medication.METHODS The bacterial isolation and identification was performed according to＇the National Clinical Inspection Procedures＇,and the drug susceptibility testing was carried out by K-B method.RESULTS The lower respiratory tract was the predominant infection site,accounting for 72.5%,followed by the urinary tract（16.0%）,secretions（5.6%）,blood（3.3%）,and other sites（2.6%）.A total of 269strains of gram-negative bacteria were isolated,among which the Pseudomonas aeruginosa,Escherichia coli,Enterobacter aerogenes,and Klebsiella pneumoniae ranked the top four species of gram-negative bacteria,accounting for 22.7%,21.9%,17.8%,and 12.6%,respectively.The main gram-negative bacteria have produced certain drug resistance to the commonly used antibiotics,and the drug resistance rate to imipenem or meropenem was less than 16.0%.CONCLUSIONIt is necessary to strengthen the monitoring of drug resistance so as to guide the reasonable clinical medication,reduce the multidrug-resistant strains,and reduce the incidence of nosocomial infections.