血液科住院患者感染细菌分布及耐药情况分析

Analysis of the distribution of infectious bacteria and the status of drug resistance in hospitalized patients of hematology department

目的探讨血液科住院患者继发感染的细菌分布及耐药情况。方法回顾性分析2015年1月至2019年12月徐州医科大学附属医院血液科1125例住院患者的临床资料,分析患者感染病原菌分布及耐药情况。结果1125例住院患者共送检微生物样本9335份,其中阳性样本1349份,革兰阴性菌阳性样本占66.4%(895/1349),革兰阳性菌阳性样本占33.7%(454/1349);血液样本占44.7%(603/1349),痰液样本占33.9%(457/1349),尿液样本占9.4%(127/1349)。分离出的细菌占比居前3位的依次为大肠埃希菌(31.0%)、金黄色葡萄球菌(21.0%)和肺炎克雷伯菌(18.0%)。大肠埃希菌对头孢曲松的耐药率高达77.2%,金黄色葡萄球菌和凝固酶阴性葡萄球菌对苯唑西林的耐药率分别为58.2%和66.7%,而对万古霉素均未产生耐药。结论血液科住院患者感染病原菌种类广泛,以大肠埃希菌和肺炎克雷伯菌为主,应重视对临床医生的抗生素处方培训,优化和规范抗生素的使用。

Objective To investigate the bacterial distribution of secondary infection and the status of drug resistance in hospitalized patients of hematology department.Methods The clinical data of 1125 inpatients in the Hematology Department of the Affiliated Hospital of Xuzhou Medical University from January 2015 to December 2019 were retrospectively analyzed,and the distribution of infectious pathogens and the status of drug resistance of these inpatients were analyzed.Results A total of 9335 microbial samples from 1125 inpatients were submitted for examination,among which 1349 were positive samples.Among 1349 positive samples,the gram-negative bacteria-positive samples accounted for 66.4%(895/1349)and the gram-positive bacteria-positive samples accounted for 33.7%(454/1349);the blood samples accounted for 44.7%(603/1349),the sputum samples accounted for 33.9%(457/1349),and the urine samples accounted for 9.4%(127/1349).The isolated bacteria whose proportion ranked as the top 3 were Escherichia coli(31.0%),Staphylococcus aureus(21.0%)and Klebsiella pneumoniae(18.0%).The drug resistance rate of Escherichia coli to ceftriaxone was as high as 77.2%,and that of Staphylococcus aureus and coagulase-negative Staphylococcus to benzoxicillin was 58.2%and 66.7%,but both had no resistance to vancomycin.Conclusions There are a wide variety of infectious pathogens in hospitalized patients of hematology department,and the Escherichia coli and Klebsiella pneumonia are predominant.More attention should be paid to antibiotic prescribing training for clinicians to optimize and standardize the use of antibiotics.