中性粒细胞缺乏伴发热患者临床分离菌的分布及药敏分析
发布时间：2018-07-26 12:00
【摘要】：目的研究中性粒细胞缺乏(粒缺)伴发热患者致病细菌的分布及其耐药性现状。方法回顾性分析2005年1月—2012年12月上海市第一人民医院血液科粒缺伴发热患者临床分离菌的分布及药敏特点。采用纸片扩散法(K-B)进行药敏试验,并按CLSI 2014年版标准判断结果。结果共检出粒缺伴发热患者临床分离菌355株,其中革兰阳性菌占29.6%,革兰阴性菌占70.4%。铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希菌、嗜麦芽窄食单胞菌和溶血葡萄球菌分别排在所有致病菌前6位。不发酵糖革兰阴性杆菌占革兰阴性菌的53.2%。甲氧西林耐药金黄色葡萄球菌(MRSA)及甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS)的检出率均已达100%,未检出对糖肽类和(或)唑烷酮类耐药的葡萄球菌和肠球菌。铜绿假单胞菌对亚胺培南和美罗培南的敏感率较低,分别为40.8%和59.2%,对头孢哌酮-舒巴坦、哌拉西林-他唑巴坦、头孢吡肟等的敏感率大于70%。肺炎克雷伯菌对美罗培南和亚胺培南等碳青霉烯类抗生素敏感率达100%,对头孢哌酮-舒巴坦、阿米卡星等的敏感率大于70%。鲍曼不动杆菌对碳青霉烯类抗生素、头孢哌酮-舒巴坦、头孢吡肟、环丙沙星及氨基糖苷类等的敏感率均大于80%。大肠埃希菌对碳青霉烯类仍保持100%敏感,对头孢哌酮-舒巴坦、头孢他啶等的敏感率大于70%。嗜麦芽窄食单胞菌对左氧氟沙星、米诺环素、头孢哌酮-舒巴坦、甲氧苄啶-磺胺甲唑的敏感率均大于90%。结论粒缺伴发热患者致病菌以革兰阴性菌为主,肠杆菌科细菌和不发酵糖革兰阴性杆菌常见,耐药情况较严重。葡萄球菌属100%甲氧西林耐药。掌握本地粒缺伴发热致病细菌的分布及药敏现状对经验性抗感染治疗方案的选择有重要的参考价值。
[Abstract]:Objective to study the distribution and drug resistance of pathogenic bacteria in patients with neutrophil deficiency and fever. Methods from January 2005 to December 2012, the distribution and drug sensitivity of clinical isolated bacteria in patients with fever in hematological department of the first people's Hospital of Shanghai were analyzed retrospectively. Drug sensitivity test was carried out by disk diffusion method (K-B), and the results were judged according to CLSI 2014 standard. Results 355 clinical isolates of Gram positive bacteria and 70.4 Gram-negative bacteria were detected. Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, Staphylococcus maltophilia and Staphylococcus haemolyticus ranked the top 6 respectively. Non-fermenting gram-negative bacilli accounted for 53.2% of Gram-negative bacteria. The detection rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococcus (MRCNS) were 100. No staphylococci and enterococci resistant to glycopeptide and / or azolone were detected. The sensitivity of Pseudomonas aeruginosa to imipenem and meropenem were 40.8% and 59.2% respectively. The sensitivity rates of Pseudomonas aeruginosa to cefoperazone-sulbactam piperacillin tazobactam cefepime were more than 70. The susceptibility rate of Klebsiella pneumoniae to carbapenem antibiotics such as meropenem and imipenem was 100%, and to cefoperazone-sulbactam and amikacin was more than 70%. The sensitivity of Acinetobacter baumannii to carbapenems, cefoperazone-sulbactam, cefepime, ciprofloxacin and aminoglycoside were all higher than 80%. Escherichia coli remains 100% sensitive to carbapenes, and more than 70% to cefoperazone-sulbactam, ceftazidime, etc. The sensitivity of Stenotrophomonas maltophilia to levofloxacin, minocycline, cefoperazone-sulbactam, trimethoprim-sulfamethazol was higher than 90%. Conclusion Gram-negative bacteria are the main pathogenic bacteria in patients with fever. Enterobacteriaceae and non-fermentative glycosaminoglycogram-negative bacilli are common, and drug resistance is more serious. Staphylococcus is 100% methicillin-resistant. It is important to know the distribution of pathogenic bacteria and drug sensitivity of local hypothalamus with fever for the selection of experiential anti-infective therapy.
【作者单位】： 上海交通大学附属第一人民医院血液科;苏州市立医院血液科;
【分类号】：R557.3;R446.5
[Abstract]:Objective to study the distribution and drug resistance of pathogenic bacteria in patients with neutrophil deficiency and fever. Methods from January 2005 to December 2012, the distribution and drug sensitivity of clinical isolated bacteria in patients with fever in hematological department of the first people's Hospital of Shanghai were analyzed retrospectively. Drug sensitivity test was carried out by disk diffusion method (K-B), and the results were judged according to CLSI 2014 standard. Results 355 clinical isolates of Gram positive bacteria and 70.4 Gram-negative bacteria were detected. Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, Staphylococcus maltophilia and Staphylococcus haemolyticus ranked the top 6 respectively. Non-fermenting gram-negative bacilli accounted for 53.2% of Gram-negative bacteria. The detection rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococcus (MRCNS) were 100. No staphylococci and enterococci resistant to glycopeptide and / or azolone were detected. The sensitivity of Pseudomonas aeruginosa to imipenem and meropenem were 40.8% and 59.2% respectively. The sensitivity rates of Pseudomonas aeruginosa to cefoperazone-sulbactam piperacillin tazobactam cefepime were more than 70. The susceptibility rate of Klebsiella pneumoniae to carbapenem antibiotics such as meropenem and imipenem was 100%, and to cefoperazone-sulbactam and amikacin was more than 70%. The sensitivity of Acinetobacter baumannii to carbapenems, cefoperazone-sulbactam, cefepime, ciprofloxacin and aminoglycoside were all higher than 80%. Escherichia coli remains 100% sensitive to carbapenes, and more than 70% to cefoperazone-sulbactam, ceftazidime, etc. The sensitivity of Stenotrophomonas maltophilia to levofloxacin, minocycline, cefoperazone-sulbactam, trimethoprim-sulfamethazol was higher than 90%. Conclusion Gram-negative bacteria are the main pathogenic bacteria in patients with fever. Enterobacteriaceae and non-fermentative glycosaminoglycogram-negative bacilli are common, and drug resistance is more serious. Staphylococcus is 100% methicillin-resistant. It is important to know the distribution of pathogenic bacteria and drug sensitivity of local hypothalamus with fever for the selection of experiential anti-infective therapy.
【作者单位】： 上海交通大学附属第一人民医院血液科;苏州市立医院血液科;
【分类号】：R557.3;R446.5
【相似文献】
相关期刊论文 前10条
1 周，
本文编号：2145942
本文链接：https://www.wllwen.com/huliyixuelunwen/2145942.html
最近更新
教材专著
