恶性肿瘤患者医院感染病原菌分布及耐药性分析

Pathogens distribution and drug resistance of nosocomial infection in malignant tumor patients

目的了解恶性肿瘤患者医院感染病原菌分布特征及其耐药性,为临床合理选用抗菌药物提供参考依据。方法通过回顾性调查方法,对河南省2016—2018年部分三甲医院住院恶性肿瘤患者送检标本进行病原菌监测与耐药性分析。结果从住院恶性肿瘤患者标本中共分离出病原菌261株,革兰阴性菌、革兰阳性菌和真菌构成比依次为51.72%、25.29%和22.99%。检出病原菌居前5位的依次为大肠埃希菌、白色念珠菌、肺炎克雷伯菌、金黄色葡萄球菌和铜绿假单胞菌。共检出多重耐药菌(MDRO)57株,占病原菌总数的21.84%,以产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和耐甲氧西林金黄色葡萄球菌(MASA)为主。大肠埃希菌、肺炎克雷伯菌对亚胺培南及美罗培南敏感,未检出耐万古霉素和利奈唑胺、替考拉宁革兰阳性菌株。结论恶性肿瘤患者医院病原菌感染以革兰阴性杆菌为主,耐药现象严重,MDRO检出率较高。

Objective To investigate the distribution characteristics of pathogenic bacteria of nosocomial infection in patients with malignant tumors and the drug resistance of main pathogens,so as to provide reference for the clinical rational selection of antimicrobial agents.Methods Retrospective investigation was used to analyze pathogen surveillance and drug resistance on specimens of malignant tumor patients admitted to some third-grade class-A hospitals in Henan province during 2016-2018.Results Totally 261 strains of pathogens were isolated,including Gram-negative bacilli(51.72%),Gram-positive bacteria,(25.29%),fungi(22.99%).Escherichia coli,Candida albicans,Klebsiella pneumoniae,Staphylococcus aureus and Pseudomonas aeruginosa were the top 5 pathogenic bacteria.57 Multidrug-Resistant Organism(MDRO)strains were detected totally,accounting for 21.84%.most were extended spectrum beta-lactamases(ESBLs)-producing Escherichia coli.(n=11)and MASA(n=6).Escherichia coli and Klebsiella pneumoniae showed highly sensitive to imipenem and meropenem.The Gram-positive strains resistant to vancomycin,teicoplanin or linezolid were not detected.Conclusion The nosocomial pathogenic infection in malignant tumor patients is mainly Gram-negative bacilli with various species,and the drug resistance is serious,the detection rate of MDRO is high.