宫颈癌患者医院感染病原菌分布与耐药性研究

Distribution and drug resistance of pathogens causing nosocomial infections in cervical cancer patients

目的分析宫颈癌患者医院感染病原菌分布与耐药性,为临床合理用药提供参考。方法选取2012年3月-2015年2月医院收治的90例宫颈癌发生医院感染患者为研究对象,VITEK-2全自动细菌鉴定仪对菌株进行鉴定;采用K-B法进行药敏试验,分析病原菌的耐药性。结果 90例患者共分离出病原菌159株,其中革兰阴性菌78株占49.1%,以大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌为主;革兰阳性菌22株占13.8%,以金黄色葡萄球菌、表皮葡萄球菌为主;真菌59株占37.1%,以白色假丝酵母菌为主;产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌和大肠埃希菌的检出率分别为40.9%和54.8%,耐甲氧西林葡萄球菌的检出率为78.0%;病原菌普遍具有耐药性,真菌对氟胞嘧啶、制霉菌素、咪康唑、两性霉素、益康唑和酮康唑的耐药率分别为2.2%、2.2%、20.4%、3.2%、35.5%、20.9%。结论宫颈癌患者医院感染病原菌通常具有多药耐药性,主要病原菌为革兰阴性菌,且耐药性较高,因此应加强对病原菌耐药性监测,以降低多药耐药菌的产生。

OBJECTIVE To observe the distribution and drug resistance of pathogens causing nosocomial infections in the cervical cancer patients so as to provide guidance for reasonable clinical use of antibiotics.METHODS A total of 90 cervical cancer patients with nosocomial infections who were treated in the hospital from Mar 2013 to Feb2015were enrolled in the study,the pathogens were identified by using VITEK-2automatic bacteria identification system.The drug susceptibility testing was performed by means of K-B method,and the drug resistance of the pathogens was analyzed.RESULTS Totally 159 strains of pathogens were isolated from the 90 patients,including78（49.1%）strains of gram-negative bacteria,22（13.8%）strains of gram-positive bacteria,and 59（37.1%）strains of fungi;the Escherichia coli,Klebsiella pneumoniae,and Pseudomonas aeruginosa were the predominant species of gram-negative bacteria;the Staphylococcus aureus and Staphylococcus epidermidis were dominant among the gram-positive bacteria;the Candida albicans was the predominant species of fungi.The isolation rates of the extended-spectrumβ-lactamase（ESBLs）-producing K.pneumoniae and E.coli were 40.9%and 54.8%,respectively;the isolation rate of the methicillin-resistant Staphylococcus was 78.0%.The pathogens were widely resistant to the antibiotics;the drug resistance rates of the fungi to flucytosine,nystatin,miconazole,amphotericin,econazole,and ketoconazole were 2.2%,2.2%,20.4%,3.2%,35.5%,and 20.9%,respectively.CONCLUSION The pathogens causing the nosocomial infections in the cervical cancer patients are multidrug-resistant;the gram-negative bacteria are dominant among the pathogens and are highly resistant to the antibiotics.It is necessary to strengthen the surveillance of drug resistance of the pathogens so as to reduce the multidrug-resistant strains.