血液科败血症细菌分布及耐药性分析

Distribution characteristics and drug resistance of pathogenic bacteria for septicemia in hematologic center

目的:分析血液科患者败血症致病细菌分布及耐药性特点,为临床治疗提供病原学依据。方法:采用回顾性分析对2011年1月-2014年12月某院血液科败血症患者血培养分离细菌进行鉴定及耐药性分析。结果:菌株82株,革兰阴性菌53株占64.6%,革兰阳性菌29株占35.4%,革兰阴性菌对头孢吡肟、丁胺卡那、哌拉西林他唑巴坦及亚胺培南耐药率低,超广谱β-内酰胺酶阳性大肠埃希菌占52.2%,且超广谱β-内酰胺酶阳性大肠埃希菌对常用抗生素的耐药率高于超广谱β-内酰胺酶阴性大肠埃希菌;革兰阳性球菌仍以葡萄球菌为主,占69.0%,耐甲氧西林葡萄球菌占葡萄球菌的55%,其对左氧氟沙星的耐药率高于甲氧西林敏感葡萄球菌(P<0.05),未发现对万古霉素及利奈唑胺耐药的葡萄球菌。结论:革兰阴性菌对头孢吡肟、哌拉西林他唑巴坦及亚胺培南耐药率低,葡萄球菌对喹诺酮类、万古霉素及利奈唑胺耐药率低。

OBJECtIVE To analyze distribution characteristics and drug resistance of pathogenic bacteria for septicemia in hematologic center, and provide a reference for clinical therapy. METHODS Characteristics of clinically isolated bacteria from patients in hematology department of Peking University Third Hospital from January 2011 to December 2014 were analyzed. RESULTS Among 82 isolates of bacteria, Gram negative bacilli accounted for 64. 6%, gram positive cocci accounted for 35.4%. Resistance rates of gram-negative bacilli to cefepime, amikacin, piperacillin tazobactam, imipenem were low. Prevalence of extended spectral beta-lactamases producing strains was 52. 2% in E. coli. ESBLs-producing enterobacteriaceae were more resistant than non extended spectral beta-lactamases producing strains in terms of antibiotic resistance rate. Staphylococcus accounted for 69. 0% of gram positive cocci, and MRS accounted for 55% of staphylococcus. MRS resistant to levofloxacin was higher than that of MSS （P〈0. 05）. No vancomycin or linezolid resistant was found. CONCLUSION Gram-negative bacilli have low resistance rates to cefepime, amikacin, piperacillin tazobactam, imipenem, and staphylococcus has low resistance rates to quinolones, vancomycin and linezolid.