白血病患者化疗后感染病原菌分布与耐药性分析

Spectrum distribution and drug resistance of leukemia patients after chemotherapy

目的探讨白血病患者化疗后感染病原菌分布及耐药性,为抗菌药物合理使用提供参考依据。方法回顾性分析2012年8月-2015年8月医院收治的670例白血病患者临床资料,记录感染发生率及病原菌构成,采用纸片扩散法检测病原菌对抗菌药物耐药性,数据采用SPSS 19.0软件进行统计分析。结果 670例白血病患者化疗后发生感染89例,感染率13.3%;感染部位主要以上呼吸道为主,共25例占28.1%;从89例感染患者中共分离出174株病原菌,以革兰阴性菌为主,共91株占52.3%;革兰阳性菌仅对万古霉素耐药率低,均<10.0%;革兰阴性菌对亚胺培南、庆大霉素耐药率低,均<10.0%。结论白血病化疗后感染的主要病原菌为革兰阴性菌,革兰阴性菌对亚胺培南、庆大霉素耐药率较低,可以作为经验性抗菌治疗最佳使用药物。

OBJECTIVE To explore the spectrum distribution and drug resistance of infected bacteria after chemotherapy,so as to provide the basis for the rational use of antibacterial drugs.METHODS A total of 670 cases of leukemia patients clinical data were collected and under retrospective analysis,who were in our hospital from Aug.2012 to Aug.2015.The incidence rate of infection and the composition of pathogens were recorded,and the drug resistance of pathogenic bacteria to antibiotics was detected by disk diffusion method.SPSS 19.0was used for data analysis.RESULTS A total of 89 cases of infection occurred in 670 cases of leukemia patients after chemotherapy,and the infection rate was 13.3%.The main part of infection was in upper respiratory tract（25cases,28.1%）.From 89 cases of infection,totally 174 strains of pathogenic bacteria were isolated,mainly gram-negative bacteria with 91 strains,accounting for 52.3%.The drug resistance rates of gram-positive bacteria to vancomycin were in a low level,all〈10.0%.Gram-negative bacteria to imipenem and gentamicin had low resistance rates,all〈10.0%.CONCLUSIONThe main pathogenic bacteria of leukemia after chemotherapy are gram-negative bacteria,which to imipenem and gentamicin have low resistance rates,so which can be used as the best antimicrobial agents.