血液内科住院老年肿瘤患者感染病原菌分布和耐药性分析研究

Analysis of infected pathogens distribution and drug resistance in hematology oncology hospitalized elderly patients

目的分析血液内科住院老年肿瘤患者感染病原菌的分布及耐药性。方法采集血液内科住院老年肿瘤患者血液标本117份,痰液80份。应用全自动血培养仪采样,API细菌鉴定系统进行病原菌检测及菌株鉴定,抗菌药物敏感性试验纸片进行药物敏感性试验。结果共分离出致病菌1513株,其中革兰氏阴性杆菌、革兰氏阳性球菌、真菌的数量及检出率分别为852株(56.3%)、283株(18.7%)和378株(25.0%)。革兰氏阴性杆菌主要以大肠埃希菌、铜绿假单胸菌和肺炎克雷伯菌为主,分别为220株(25.8%)、83株(9.7%)和62株(7.2%);真菌主要为白色念珠菌,检出率为8.6%。抗菌药物敏感性试验结果显示,革兰氏阴性杆菌对美罗培南、亚胺培南敏感度高,对氨苄西林、哌拉西林有很高的耐药性。结论血液内科老年肿瘤患者易发生院内感染,且容易产生耐药性,临床上应通过抗菌药物敏感性试验结果合理选择药物,以减少病原菌耐药性,提高临床治愈率。

Objective To investigate distribution and drug resistance of pathogens infecting senior patients with tumors hospitalized in department of hematology. Methods 117 blood and 80 sputum speci- men were collected from senior patients with tumors hospitalized in department of hematology. Automated blood culture system was used for sampling, API bacterial identification system for pathogen detection and strain identification, and antimicrobial susceptibility test paper for drug susceptibility testing. Results 1513 pathogens were isolated, including gram-negative bacteria, gram-positive bacteria and fungi, detection strains were 852 （56. 3% ） ,283 （ 18. 7% ） and 378 （25.0%）. Gram-negative bacteria mainly were consisted of Escherichia coli [ 220 （25.8%） ~, Pseudomonas aerations chest bacteria [ 83 （9. 7% ） ] and Klebsiella pneu- monia [ 62 （7.2%）]. The detection rate of fungi was 8.6%, and domaniting one was Candida alb cans. Antimicrobial susceptibility test results show that Gram-negative bacilli had high sensitivity to kerosene and impanel, and high resistance to apically and piperacillin. Conclusions Senior patients with tumors hospitalized in department of hematology were prone to nosocomial infections, and easy to produce drug re- sistance senior patients with tumors hospitalized in department of hematology. Antimicrobial susceptibility test results should be considered into the choice of drugs clinically to reduce pathogen resistance and to im- prove clinical cure rate.