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目的:了解肿瘤患者医院感染肠杆菌科细菌的好发部位及耐药性,提供流行病学资料,为临床合理应用抗菌药物提供依据。方法:回顾性分析168例发生肠杆菌科细菌医院感染的肿瘤患者病历资料;采用WHONET5.6版本软件进行耐药性分析。结果:2013-2014年肠杆菌科细菌医院感染的肿瘤患者共168例,其感染高发部位依次为:呼吸道48.2%、泌尿道24.4%、皮肤、黏膜12.5%;分离到200株肠杆菌科细菌,32株为复数菌感染,其中大肠埃希氏菌、肺炎克雷伯氏菌、奇异变形杆菌较常见,分别占30.0%、20.5%、15.0%;药敏数据显示:本组200株肠杆菌科细菌产超广谱内酰胺酶(ESBLs)细菌检出率为30.5%,检出肺炎克雷伯菌和大肠埃希菌共101株,其中产ESBLs细菌检出61株,检出率为60.40%;耐药率最高的抗菌药物是氨苄西林和庆大霉素,每种病原菌均超过75%;阿米卡星、氨曲南、亚胺培南、美罗培南、哌拉西林/他唑巴坦敏感性较高,耐药率均<20.0%。结论:肿瘤患者医院感染肠杆菌科细菌临床分布上产ESBLs大肠埃希氏菌、肺炎克雷伯氏菌有所上升,所分离细菌耐药性严重,只有做到合理使用抗菌药物,才能避免多药耐药菌株的产生,减轻个人和社会的医疗费用负担。
OBJECTIVE: To understand the predilection sites and drug resistance of Enterobacteriaceae in hospital patients with tumor, provide epidemiological data and provide basis for rational use of antibacterials in clinics. Methods: The clinical data of 168 patients with enterobacteriaceae nosocomial infection were retrospectively analyzed. The drug resistance was analyzed by WHONET5.6 software. Results: A total of 168 patients with enterobacteriaceae nosocomial infection from 2013 to 2014 were infected with Enterobacteriaceae. The most common infectious diseases were respiratory tract 48.2%, urinary tract 24.4%, skin and mucosa 12.5% Among them, 32 strains were complex bacterium, of which Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were common, accounting for 30.0%, 20.5% and 15.0% respectively. The data of drug susceptibility showed that 200 strains of Enterobacteriaceae The detection rate of bacteria producing ESBLs was 30.5%, and 101 strains of Klebsiella pneumoniae and Escherichia coli were detected. Among them, 61 strains of ESBLs producing bacteria were detected, the detection rate was 60.40% ; The highest rates of antibacterial drugs were ampicillin and gentamycin, each of which exceeded 75%; amikacin, aztreonam, imipenem, meropenem, piperacillin / tazobactam High sensitivity, resistance rates were <20.0%. Conclusion: The clinical distribution of Enterobacteriaceae in hospital patients with cancer is characterized by ESBLs-producing Escherichia coli, Klebsiella pneumoniae increased, and the drug resistance of the isolated bacteria is serious. Only by using antibacterials rationally can we avoid more The emergence of drug-resistant strains reduces the burden on individuals and society for medical expenses.