急性白血病患者合并感染病原菌分布及耐药性分析

Analysis of distribution and antimicrobial resistance of pathogens isolated from patients with acute leukemia

目的分析急性白血病患者合并感染的病原菌分布及耐药性,为临床防治感染提供依据。方法菌株分离与鉴定按照《全国临床检验操作规程》进行细菌分离培养,药敏试验按照CLSI规定的判断标准进行判定。结果 215株病原菌中,革兰阴性杆菌占57.67%,革兰阳性球菌占28.37%,真菌占13.95%;大肠埃希菌和肺炎克雷伯菌对碳青霉烯类抗菌药物敏感,其次对阿米卡星和头孢他啶敏感,铜绿假单胞菌对哌拉西林/他唑巴坦耐药率最低,为12.5%,金黄色葡萄球菌对糖肽类抗菌药物敏感,而对青霉素类药物耐药。结论急性白血病患者是感染的易感人群,以革兰阴性杆菌感染为主,对常用抗菌药物耐药性增加,积极防治感染,有助于降低感染相关死亡率。

Objective To analyse the clinic distribution and antimicrobial resistance of pathogens isolated from patients with acute leukemia and to provide evidence for clinical prevention and control infection. Methods Pathogenic strains were cultured and identified according to the National Guide to Clinical Laboratory Procedures. Drug susceptibility test was identified by the CLSI standard. Results Among 215 strains of pathogens, gram - negative bacilli, gram - positive bacilli and fungi accounted for 57.67% , 28.37% and 13.95% respectively. The susceptibility test results indicated Escherichia coli and Klebsiell were susceptible to carbapenems antibiotics, secondly to amikacin and ceftazidime. The resistance rate of pseudomonas aeruginosa to piperacillin/tazobactam was 12.50%. Staphylococcus aureus was susceptible to glyeopeptides antibiotics, but resistant to ampicillin. Conclusion Patients with acute leukemia are susceptible to infection; gram - negative bacteria are the most common pathogens and have considerable resistance to commonly used antibiotics. Effective prevention and control measures may reduce the mortality.