COVID-19后血液病患者呼吸道感染菌种分布及耐药性分析

Drug Resistance Analysis and Distribution of Respiratory Infection Bacteria in Blood Disease Patients After COVID-19

目的 对COVID-19后血液病患者呼吸道感染菌种分布及耐药性分析。方法 收集宿迁市第一人民医院2021年1月—2023年10期间收治的156例血液病合并呼吸道感染患者作为对象进行研究,采集患者呼吸道标本,使用VITEK2Compact全自动细菌鉴定及药敏分析系统和纸片扩散法,进行菌种鉴定和药敏试验,分析患者临床诊断、特征、菌种类型以及耐药性。结果 156例患者中,细菌感染68例,主要包括铜绿假单胞菌11例、嗜麦芽窄食单胞菌11例、肺炎克雷伯菌肺炎亚种8例、流感嗜血杆菌7例、卡他莫拉菌7例、大肠埃希氏菌5例;真菌感染88例,以白色念珠菌感染为主,43例,其次为曲霉菌18例;铜绿假单胞菌对头孢吡肟、头孢他啶、头孢哌酮、舒巴坦以及左氧氟沙星的敏感性为90.91%;嗜麦芽窄食单胞菌对复方新诺明、米诺环素敏感性为100%;肺炎克雷伯杆菌对阿米卡星、氨曲南、厄他培南、复方新诺明、哌拉西林/他唑巴坦、头孢吡肟、头孢替坦、亚胺培南的敏感性为62.5%;流感嗜血杆菌对氨曲南、氯霉素、美罗培南、头孢曲松、左氧氟沙星敏感敏感性高于85.71%。结论 我院血液病患者呼吸道感染细菌以铜绿假单胞菌和嗜麦芽窄食单胞菌为主,真菌以白色念珠菌和曲霉菌为主,不同病菌对常用抗菌药物的耐药性存在差异,临床治疗需结合药物敏感性针对性用药。

Objective To analyze drug resistance and the distribution of respiratory tract infections in patients with hematological diseases after COVID-19.Methods A total of 156 patients with hematological diseases and respiratory tract infections admitted to the First People's Hospital of Suqian City from January 2021 to October 2023 were collected as the study subjects.Respiratory specimens were collected from patients,and the VITEK2Compact fully automatic bacterial identification and drug sensitivity analysis system and paper diffusion method were used for bacterial identification and drug sensitivity testing.The clinical diagnosis,characteristics,bacterial types,and drug resistance of the patients were analyzed.Results Among 156 patients,there were 68 cases of bacterial infections,mainly including 11 cases of Pseudomonas aeruginosa,11 cases of Stenotrophomonas maltophilia,8 cases of Klebsiella pneumoniae subspecies pneumonia,7 cases of Haemophilus influenzae,7 cases of Moraxella catarrhalis,and 5 cases of Escherichia coli;There were 88 cases of fungal infections,with Candida albicans being the main infection,43 cases,followed by 18 cases of Aspergillus;The sensitivity of Pseudomonas aeruginosa to cefepime,ceftazidime,cefoperazone sulbactam,and levofloxacin is 90.91%;The sensitivity of Stenotrophomonas maltophilia to compound sulfamethoxazole and minocycline is 100%;Klebsiella pneumoniae has a sensitivity of 62.5%to amikacin,amtrebuconam,ertapenem,compound sulfamethoxazole,piperacillin/tazobactam,cefepime,cefotetan,and imipenem;Haemophilus influenzae has a sensitivity of over 85.71%to aminotriaxone,chloramphenicol,meropenem,ceftriaxone,and levofloxacin.Conclusions The respiratory tract infections of patients with hematological diseases in our hospital are mainly caused by Pseudomonas aeruginosa and Stenotrophomonas maltophilia,while the fungi are mainly Candida albicans and Aspergillus.There are differences in the resistance of different bacteria to commonly used antibiotics,and clinical treatment needs to be combined with drug sensitivity and targeted medication.