肿瘤患者合并产超广谱β-内酰胺酶细菌感染的耐药性分析

Drug resistance of bacterial producing extended-spectrum β lactamases in cancer patients

目的:探讨肿瘤患者合并产超广谱β-内酰胺酶(extended-spectrumβlactamases,ESBLs)的大肠埃希菌和肺炎克雷伯菌的发生比例及对临床常用抗菌药物的耐药情况。方法:收集2013年6月至2014年9月郑州人民医院各类临床标本中所得到的大肠埃希菌和肺炎克雷伯菌进行分析。结果:肿瘤患者共分离出大肠埃希菌116株,其中42株产ESBLs,比例为36.2%;分离出肺炎克雷伯菌102株,其中24株产ESBLs,比例为23.5%。两年来,大肠埃希菌ESBLs阳性菌对临床常用抗菌药物表现出较高的耐药性,耐药率上升非常显著;非产ESBLs大肠埃希菌对大多数抗菌药物仍保持较高的敏感率;但2014年未产ESBLs大肠埃希菌的耐药性比2013年明显上升。肺炎克雷伯菌的情况与大肠埃希菌相似。结论:合理使用抗菌药物对控制肿瘤合并ESBLs患者具有重要意义。

Objective： To study the characteristics of antibiotic resistance of Escherichia coli and Klebsiella pneumoniae producing extended-spectrum β lactamases（ ESBLs） in cancer patients. Methods： Collected and analyzed Escherichia coli and Klebsiella pneumoniae from obtained in all types of clinical specimens from June 2013 to September 2014 in People＇s Hospital of Zhengzhou. Results： Total of 116 Escherichia coli were isolated from cancer patients,including 42 producing ESBLs,the ratio was 36. 2%,and 102 Klebsiella pneumoniae were isolated,including24 producing ESBLs,the ratio was 23. 5%. Over the past two years,Escherichia coli producting ESBLs showed high resistance to some antimicrobial agents,and the resistance rates rised significantly. Escherichia coli not producting ESBLs was remained high sensitive rate to most antimicrobial agents. But in 2014,the drug resistance of Escherichia coli not producting ESBLs increased obviously than 2013. Klebsiella pneumoniae was similar to Escherichia coli. Conclusion： Rational use of antimicrobial agents has great significance to control the tumor in patients with ESBLs.