肿瘤患者医院感染革兰阳性球菌的分布与耐药性分析

发布时间：2018-07-27 09:48

【摘要】：目的调查肿瘤患者医院感染革兰阳性球菌的分布及其对常用抗菌药物的耐药性,为临床合理使用抗菌药物提供依据。方法回顾性调查中山大学肿瘤防治中心2014年172例革兰阳性球菌感染患者临床资料,所有标本均采用法国生物梅里埃公司VITEK-32微生物鉴定系统进行菌种鉴定和耐药性分析,并采用EXCEL8.0和WHONET5.4软件对感染者的基本情况、科室分布、标本分布和耐药性进行分析。结果医院感染患者中共分离出172株革兰阳性球菌,主要来源于咽拭子、痰及引流液;革兰阳性球菌分离率较高的科室为放疗科、ICU及胸科;革兰阳性球菌以链球菌属和葡萄球菌属为主,分别占43.6%和40.1%;链球菌属对红霉素及磺胺甲VA唑/甲氧苄啶耐药率85.0%,对利奈唑胺和万古霉素敏感率为100.0%;肠球菌属对克林霉素及红霉素耐药严重,对替考拉宁和替加环素敏感率为100.0%,此外发现1株耐万古霉素肠球菌(VRE);葡萄球菌属对青霉素、苯唑西林的耐药性85.0%,而对利奈唑胺和替加环素敏感率为100.0%;耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为60.0%和89.8%。结论医院感染革兰阳性球菌标本主要来源于呼吸道,以链球菌属和葡萄球菌属为主;其耐药性较严重,多药耐药明显,出现了VRE,临床应提高警惕。
[Abstract]:Objective to investigate the distribution of gram positive cocci in nosocomial infection of cancer patients and their resistance to common antibiotics, and to provide a basis for clinical rational use of antibiotics. Methods 172 cases of gram-positive cocci from the cancer prevention and control center of Zhongshan University in 2014 were investigated. All the specimens were used in French biological mailler. The VITEK-32 microbial identification system was used to identify the strains and analyze the drug resistance. The basic situation of the infected people, the distribution of the section, the distribution of the specimens and the drug resistance were analyzed with the software of EXCEL8.0 and WHONET5.4. The results showed that 172 strains of gram-positive cocci were isolated from the hospital infected patients, mainly from swabs, sputum and drainage. The higher isolation rate of the staphylococci was the radiotherapy department, ICU and the chest department, gram-positive cocci were mainly Streptococcus and Staphylococcus, 43.6% and 40.1%, respectively, the resistance rate of Streptococcus to erythromycin and sulfamethoxazole / trimethoprim was 85%, and the susceptibility rate to linezolid and vancomycin was 100%, and Enterococcus to clindamycin and erythromycin. The susceptibility rate of teicoplanin and tegacycline was 100%, and 1 strains of vancomycin resistant Enterococcus (VRE) were found. The resistance of Staphylococcus to penicillin and zoxicillin was 85%, and the susceptibility rate of linezolid and tenacycline was 100%; methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase negative grapes were found. The detection rates of staphylococci (MRCNS) were 60% and 89.8%. respectively. Conclusion the main specimens of gram positive cocci from hospital infection were mainly from the respiratory tract, mainly Streptococcus and Staphylococcus, the drug resistance was serious, the multidrug resistance was obvious, and the VRE was found. The clinical should be vigilant.
【作者单位】：中山大学肿瘤防治中心医院感染管理科;中山医学院临床医学系;
【基金】：国家卫生计生委专项基金资助项目(1311200006402)
【分类号】：R446.5

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