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目的研究血液恶性肿瘤患者并发下呼吸道感染时病原学分布及药敏情况。方法对45例血液恶性肿瘤住院患者的痰细菌培养及药敏试验结果进行回顾性分析。结果45例血液恶性肿瘤患者的痰标本分布为:革兰氏阴性菌66.5%,其中铜绿假单胞菌16.9%,嗜麦芽假单胞菌7.7%,肺炎克雷伯杆菌13.8%,鲍曼不动杆菌9.2%;革兰氏阳性菌18.5%,以金黄色葡萄球菌为主,占12.3%;真菌15.4%。药敏试验显示革兰氏阴性菌对广谱抗菌素产生耐药,中性粒细胞的下降与感染密切相关。结论临床上一方面加强支持治疗,改善机体免疫力,缓解粒细胞缺乏,另一方面,积极开展痰细菌培养和药敏试验,合理使用抗生素,减少耐药菌株的产生,可联合抗霉菌治疗。
Objective To study the etiological distribution and drug sensitivity of patients with hematological malignancies complicated by lower respiratory tract infection. Methods 45 patients with hematological malignancies sputum bacterial culture and drug sensitivity test results were retrospectively analyzed. Results The distribution of sputum samples from 45 patients with hematological malignancies was: Gram-negative bacteria 66.5%, including 16.9% of Pseudomonas aeruginosa, 7.7% of Pseudomonas maltophilia, 13.8% of Klebsiella pneumoniae, Acinetobacter 9.2%; Gram-positive bacteria 18.5%, mainly Staphylococcus aureus, accounting for 12.3%; fungi 15.4%. Susceptibility tests showed that Gram-negative bacteria resistant to broad-spectrum antibiotics, neutrophil decline and infection are closely related. Conclusion On the one hand, clinical support is strengthened to improve immunity and alleviate agranulocytosis. On the other hand, sputum bacterial culture and drug susceptibility testing are actively carried out. Rational use of antibiotics and reduction of drug-resistant strains can be combined with anti-mold treatment.