肿瘤患者院内下呼吸道细菌感染的病原菌分布及药物敏感性

Bacterial Spectrum and Drug Sensitivity of Nosocomial Lower Respiratory Tract Infection of Malignant Tumor in-Patients

目的 :研究我院住院恶性肿瘤患者的院内下呼吸道细菌感染病原菌的分布及药物敏感性。方法 :对1996年～ 2 0 0 0年间住我院并发院内下呼吸道感染的恶性肿瘤患者的 4 4 8份痰标本进行细菌学培养 ,阳性菌以K B法进行药敏试验。结果 :5年中分离出病原菌 333株 ,以革兰阴性菌为主 ,病菌检出率为 74 33%。革兰阴性菌以铜绿假单孢菌为主 (19 6 %～ 2 9.4 % ) ,革兰阳性菌以金黄色葡萄球菌为主 (12 .8%～ 2 4 7% ) ;药敏试验结果提示铜绿假单孢菌对第三代头孢菌素、三代氟喹诺酮、氨基糖甙类较为敏感 ,但对头孢曲松敏感性降低 (P <0 .0 5 ) ;金黄色葡萄球菌对万古霉素高度敏感 ,对苯唑西林的药物敏感性明显降低 ,由 4 5 5 %下降到 11 1% (P <0 .0 5 ) ,对头孢曲松敏感性亦降低 (P <0 .0 5 ) ;常用抗生素对肠杆菌属多有较高抗菌活性。结论 :我院住院肿瘤患者的院内下呼吸道感染以革兰阴性菌为主 ,但革兰阳性菌也是重要致病菌 ,应根据药敏试验结果选择抗生素 。

Objective: To study the bacterial spectrum and drug sensitivity changes of nosocomial lower respiratory tract infection among our malignant tumor in patients.Methods:The sputum specimens taken from 448 malignant tumor in patients during 1996 2000 were cultured and their drug sensitivity tests were done by K B method for those positive specimens.Results:during these five years,333 pathogenic species were detected among nosocomial lower respiratory tract infection in patients.Among these pathogenic species,the most prevalent species were Gram negative bacteria with average positive detection 74.33%.ln Gram negative bacteria,the most common species was pseudomonas aeruginosa(19.6%～29.4%),staptylococcus aureus(12.8%～24.7%).And among Gram positive bacteria,staptylococcus aureus(12.8%～24.7%)was the major species.The results of drug sensitivity tests showed that the sensitivity of pseudomonas aeruginosa to 3 rd cephalosporin,3 rd Quinolones and Amikacin were higher but the sensitivity was lowered to ceftriaxone( P<0.05 ).The sensitivity of staphylococcus aureus to vancomycin was high but the sensitivity was lowered to Oxacrugcillin from 45.5% to 11.1%( P<0.05 )and it was also lowered to ceftriaxone( P<0.05 ).The common antibiotics usually had higher sensitivity to coli bacilli.Concluson:Gram negative bacteria are most prevalent pathogenic species in lower respiratory tract infection of malignant tumor in patients,while Gram positive bacteria are still the important pathogenic species.We should select antibiotics according to the results of drug sensitivity tests and consider the spectrum of pathogenic species as well as the changes of drug sensitivity to treat in patients with lower respiratory tract infection.