恶性肿瘤患者常见病原菌分布及耐药性监测

Surveillance of distribution and antimicrobial resistance of common pathogens in patients with malignant tumors

目的分析恶性肿瘤患者病原菌分布及耐药性趋势,为临床预防控制和治疗其医院感染提供实验室依据。方法收集本院2011年-2015年从恶性肿瘤患者分离出的病原菌697株,纸片扩散法(K-B)进行药敏试验,WHONET5.6软件统计分析资料。结果 697株标本中前5位病原菌分别为肺炎克雷伯菌133株(19.1%)、大肠埃希菌108株(15.5%)、铜绿假单胞菌72株(10.3%)、金黄色葡萄球菌62株(8.9%)、鲍曼不动杆菌43株(6.2%)。革兰阴性菌占64.4%,革兰阳性菌占27.8%,真菌占7.7%。MRSA和MRCNS检出率分别为40.3%和72.5%。大肠埃希菌和肺炎克雷伯菌中ESBLs检出率分别为64.8%和30.1%,检出耐碳青霉烯类肺炎克雷伯菌(4株)和大肠埃希菌(1株)。鲍曼不动杆菌对亚胺培南和美罗培南耐药率分别16.3%和19.4%;铜绿假单胞菌对亚胺培南和美罗培南耐药率分别为12.5%和9.7%。真菌(1-3)-β-D-葡聚糖阳性率为62.3%。结论恶性肿瘤患者病原菌分布和耐药性变化有自己的特点,已监测到耐碳青霉烯类肠杆菌科细菌。

Objective To analyse the distribution and antibacterial resistance of pathogens in patients with malignant tumors, so as to provide laboratory basis for clinical control, prevention and therapy of nosocomial infecion in malignant tumor patients. nettaods A total of 697 strains of pathogenic bacteria were isolated from specimens of malignant tumor patients in our hospital from 2011 to 2015. Antimicrobial susceptibility testing was carried out by means of Kirby - Bauer（ KB）, and all data were analyzed by WHONET 5.6 software. Results The top 5 bacteria were K. pneumoniae（ 133, 19.1% ）, E. coli（ 108, 15.5% ）, P. aeruginosa（72, 10.3% ） , S. aureus（62, 8.9% ）, and A. baumannii（43, 6.2% ） . Of which Gram negative bacillus accounted for 64.4% , Gram - positive accounted for 27.8% andfung/accounted for 7.7%. The detection rates of MRSA and MRCNS were 40.3% and 72.5% respectively. And the detection rates of ESBLs was 64.8% and 30. 1% in E. coli and in K. pneumoniae, respectively. Only one strain was resistant to carbapenems in E. coli and four strains in K. pneumoniae. The resistance rate of A. baumannii to imipenem and meropenem was respectively 16.3 and 19.4%, and for P. aeruginosa was 12.5% and 9.7%. The positive rate of （ 1 - 3） -β - D - glucan was 62.3 %. Conclusion The distribution of pathogenic bacteria and drug resistance in patients with malignant tumor has its own characteristics, and carbapenem- resistant enterobacteriaceae has been detected.