肿瘤患者两种ESBLs菌株医院感染特征及其耐药性研究

The hospital infection characteristics and drug resistance of two ESBLs strains in tumor patients

目的研究肿瘤患者产超广谱β-内酰胺酶(ESBLs)细菌感染特点及其耐药性。方法采用细菌分离鉴定技术和药敏试验方法,对某医院2014年度住院肿瘤患者送检病原学标本进行检测与分析。结果该医院在2014年度从肿瘤患者送检的感染类标本中共分离出大肠埃希菌81株和肺炎克雷伯菌62株。81株大肠埃希菌中检出产ESBLs43株,检出率为53.09%;62株肺炎克雷伯菌中检出产ESBLs12株,检出率为19.35%。43株产ESBLs大肠埃希菌中有11株分离自感染患者,感染率为25.58%,以手术部位感染居多;12株产ESBLs肺炎克雷伯菌中有6株分离自感染患者,感染率为50.00%,以呼吸道感染居首位。产ESBLs菌株对常用抗菌药物普遍耐药,仅对碳青霉烯类和酶抑制复合剂等抗菌药物较敏感。结论恶性肿瘤患者感染产ESBLs菌株主要是大肠埃希菌和肺炎克雷伯菌,呈现广泛耐药性,应加强监测和在药敏试验指导下选用抗菌药物。

Objective To analyze the hospital infection characteristics and drug resistance of two ESBLs strains. Methods All kinds of infections specimen collected from hospitalized patients during the year 2014 were detected and analyzed ap- plying the bacteria isolation and identification technology and drug sensitivity test method. Results There were 81 strains of E. coli and 62 strains K. pneumonia among clinical infectious specimens during the year 2014. Among these strains,43 strains were （50.09%） ESBLs - producing E. coli and 12 strains （ 19.35% ） were ESBLs - producing K. pneumonia. 11 strains were isolated from 43 producing ESBLs of E. coli strains with the infection rate was 25.58%. The ESBLs - producing E. coli strains were mainly from the surgical site. Among the 12 strains of ESBLs, 6 strains of ESBLs - producing E. coli were detected from the respiratory system that accounting for 50%. ESBLs - producing strains were resistant to most antimi- crobials,while highly sensitive to Carbapenem, Piperacillin/Tazobaetam and Amikacin. Conclusion Strains of ESBLs - producing E. coli and K. pneumoniae are important strains of nosocomial infection of the tumor patients, with the extensive drug resistance, Sothe bacteriological examination should be strengthened and antibiotics should be used rationally based on the drug susceptibility results.