恶性血液病患者血流感染病原菌特点及药物敏感性分析

Malignant Blood Infection in Patients with Hematologic Diseases Features of Pathogenic Bacteria and Drug Sensitivity Analysis

目的:探讨恶性血液病患者血流感染病原菌特点及药物敏感性,为临床合理用药提供可靠依据。方法:选取宣汉县人民医院2010年1月至2013年1月1268份恶性血液疾病患者血流感染的血培养标本,所有标本均进行菌种鉴定和药敏试验,统计病原菌分布情况及药物敏感性。结果:1268份血液培养标本中,检出94株病原菌,阳性率为7.41%;革兰阳性菌34株,占36.17%;革兰阴性菌55株,占58.51%;真菌5株,占5.32%;其中,以革兰阴性菌最为常见(P<0.01);选择4种常见致病菌(人葡萄球菌、表皮葡萄球菌、肺炎克雷伯菌及大肠埃希菌)进行药敏试验,其中,革兰阳性菌对利福平及万古霉素最为敏感;革兰阴性菌对美洛培南、亚胺培南及丁胺卡那最为敏感。结论:恶性血液病患者血流感染发生率较高,病原菌主要为革兰阴性菌,且对多种抗菌药物均具有耐药性,临床治疗中应根据患者药敏试验结果合理选择抗菌药物。

Objective： To investigate the characteristics of pathogenic bacteria infection and drug sensitivity of blood flow in patients with malignant blood diseases, and provide a reliable basis for clinical rational drug use. Method： Specimens were selected in Xuanhan People＇s Hospital in 2010 January -2013 years in January 1268 of malignant blood disease in patients with bloodstream infection blood culture ; all the samples were subjected to strain identification and drug sensitivity test, the distribution of pathogens and drug sensitivity in statistics. Result： 1268 copies of blood culture samples, 94 strains of bacteria were isolated. The positive rate was 7.41%; 34 strains of gram positive bacteria, accounting for 36.17%; 55 gram negative bacteria, accounting for 58.51% ; 5 strains of fungi, accounting for 5.32% ; among them, the most common gram negative bacteria （ P 〈 0.01 ） ; 4 kinds of common pathogenic bacteria （ Staphylococcus, epidermis Staphylococcus, Klebsiella pneumoniae and Escherichia coli） drug sensitivity test, among them, gram positive bacteria was the most sensitive to rifampicin and vancomycin; gram negative bacteria to meropenem, imipenem and amikacin was the most sensitive. Conclusion： The blood flow in patients with malignant blood diseases infection rate of pathogens are mainly gram negative bacteria, and for a variety of antibacterial drugs have resistance, should be a reasonable choice of antibiotics according to the drug sensitivity test results of patients in clinical treatment.