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目的研究肿瘤化疗患者医院感染病原菌的耐药性以及感染因素,指导控制和治疗肿瘤化疗患者医院感染。方法选取2011年3月-2012年12月进行化疗的肿瘤患者685例,记录发生感染患者的病例数;对感染患者送检标本进行分离培养病原菌;采用K-B琼脂试验检测病原菌的耐药性,并研究感染的危险因素。结果 685例肿瘤化疗患者发生医院感染75例,感染率10.95%;感染部位以呼吸道为主占53.33%,其次为消化道、泌尿道、生殖道及皮肤感染,分别占17.34%、12.00%、8.00%及5.33%;共分离出病原菌82株,其中革兰阳性菌36株占43.90%,革兰阴性菌39株占47.56%,真菌7株占8.54%;革兰阳性菌对利奈唑胺、革兰阴性菌对美罗培南、真菌对制菌霉素的耐药率均为0;肿瘤患者发生医院感染的危险因素为患者年龄大、化疗时间长、合并其他疾病、进行侵入性操作、未应用抗菌药物预防。结论肿瘤化疗患者是医院感染的高危人群,医护工作人员应采取措施控制化疗患者医院感染的发生,选用耐药率低的抗菌药物进行及时治疗。
Objective To study the drug resistance and infection factors of nosocomial pathogenic bacteria in patients with tumor chemotherapy and to guide the control and treatment of nosocomial infections in patients with tumor chemotherapy. Methods A total of 685 cancer patients who underwent chemotherapy from March 2011 to December 2012 were selected and the number of cases with infection was recorded. Pathogens were isolated and cultured in infected patients, and KB agar assay was used to detect the drug resistance of pathogens Study the risk factors for infection. Results There were 75 cases of nosocomial infection in 685 patients with cancer infection, the infection rate was 10.95%. The main infection area was respiratory tract, accounting for 53.33%, followed by gastrointestinal tract, urinary tract, genital tract and skin infections, accounting for 17.34%, 12.00% and 8.00% % And 5.33% respectively. A total of 82 pathogens were isolated, of which 36 strains were Gram-positive bacteria, 43.90% Gram-negative bacteria, 39 strains were Gram-negative bacteria, accounting for 47.56% and 7 strains were fungi, accounting for 8.54%; Gram- Gram-negative bacteria were resistant to meropenem and fungi were all 0; the risk factors of nosocomial infection in patients with cancer were age-old, long-term chemotherapy, combined with other diseases, invasive operation, no antibacterial Drug prevention. Conclusions Tumor chemotherapy patients are the high risk of nosocomial infection. Health care workers should take measures to control the occurrence of nosocomial infections in patients with chemotherapy, and choose antimicrobial drugs with low resistance rate for timely treatment.