血液科感染患者致病菌的临床资料分析

Analysis of the Characteristics of Pathogens in Hematology Department

目的:探讨血液病患者的感染特点,为临床治疗提供病原学依据。方法:回顾性分析北京友谊医院2008年7月至2011年7月血液科住院患者临床分离出病原菌的情况。结果:原发病以血液系统恶性肿瘤为主。共培养出致病菌357株,包括革兰阴性杆菌(40.8%);革兰阳性球菌(24.1%);真菌(35.1%)。引起感染最常见的革兰阴性杆菌为铜绿假单胞菌,最常见的革兰阳性球菌为粪肠球菌,最常见的真菌为白色假丝酵母菌。革兰阴性杆菌来源为血29.4%,痰46.6%,尿10.3%;革兰阳性球菌来源为血14%,痰47.7%,尿10.4%;真菌来源为血8%,痰60.8%,尿4%。66.4%真菌感染患者中性粒细胞<1.5×109/L。结论:血液病感染的致病菌以革兰阴性杆菌为主,呼吸道是主要感染部位。对于中性粒细胞减少的血液病感染患者,真菌感染的几率明显增加,经验性抗真菌治疗具有一定的意义。

Objective： To analyze the characteristics of nosocomial of hematological disease and provide references for clinical therapy.Methods： The distribution of clinically isolated pathogens from the patients in hematology department of Beijing Friendship Hospital from July 2008 to July 2011 was analyzed.Results： The patients with malignant hematopathy were the main population of nosocomial infections.Among the total of 357 isolates of pathogen,the Gram-negative bacilli were 40.8%,the Gram-positive cocci were 24.1 % and the fungi were 35.1%.Pseudomonas aeruginosa was the most frequently isolated Gram-negative bacilli,Enterococcus faecalis was the most frequently isolated Gram-positive cocci,and Candida albicans was most frequently isolated fungi.The rate of Gram-negative bacilli from blood,sputum and urine culture was 29.4 %,46.6 % and10.3 %,respectively.The rate of Gram-positive cocci from blood,sputum and urine culture was 14 %,47.7% and10.4 %,respectively.The rate of fungi from blood,sputum and urine culture was 0.8 %,60.8% and 4 %,respectively.The patients with neutrophil count less than 1.5 ×109/L accounted for 66.4% fungi infection cases.Conclusion： The Gram-negative bacilli were the most common pathogens.Respiratory tract was the important site.The rate of fungal infection obviously increased along with neutropenia.It was of great significance to use empirical antifungal treatment.