血液科患者血培养分离菌与原发病及年龄分层的相关性分析

发布时间：2018-11-26 12:24

【摘要】：目的按照不同原发病及年龄分层统计、分析血液病患者血培养分离菌分布和药敏结果,为临床合理使用抗菌药物提供依据。方法对血液科2013年1月-2014年12月血培养标本的结果和患者的一般资料进行回顾性分析。结果共送检1 695份血培养标本,阳性标本302份,阳性率为17.8%,分离到113株革兰阳性菌(37.4%),170株革兰阴性菌(56.3%),19株真菌(6.3%)。血培养阳性率最高的原发病是骨髓瘤(26.5%),其次是白血病(24.3%)。年龄分组中60~80岁患者血培养阳性率为17.9%,60岁阳性率为17.8%。血培养阳性标本中,革兰阳性菌阳性率最高的年龄段为60~80岁,阳性率为39.5%。革兰阳性菌中以葡萄球菌属居首,革兰阴性菌中肠杆菌科细菌最多。革兰阳性菌对万古霉素、替加环素有较高的敏感率,革兰阴性菌对亚胺培南、头孢替坦有较高的敏感率。葡萄球菌属和肠球菌属对青霉素G均有较高耐药率。结论 1 695份血液科患者血培养阳性标本分析显示革兰阴性菌,尤其是大肠埃希菌在血流感染中占多数。血培养分离菌对常见抗菌药物耐药率较高,而检出原发病最多为骨髓瘤;60~80岁患者比率最高。对不同原发病、年龄分层血培养分离菌的分布和敏感及耐药性进行分析,有助于指导临床合理用药。
[Abstract]:Objective to analyze the distribution of isolated bacteria and drug sensitivity in blood culture of patients with hematologic diseases according to different primary diseases and age stratification, and to provide evidence for rational use of antimicrobial agents in clinic. Methods the results of blood culture from January 2013 to December 2014 in hematology department and the general data of patients were retrospectively analyzed. Results A total of 1 695 blood culture specimens were tested, 302 positive specimens were positive, the positive rate was 17.8%. 113 Gram-positive bacteria (37.4%), 170 Gram-negative bacteria (56.3%) and 19 fungi (6.3%) were isolated. The highest positive rate of blood culture was myeloma (26.5%), followed by leukemia (24.3%). In the age group, the positive rate of blood culture was 17.9% and 17.8% respectively. The highest positive rate of Gram-positive bacteria in blood culture samples was 60 ~ 80 years old, and the positive rate was 39.5%. Among Gram-positive bacteria, Staphylococcus was the most, and Gram-negative bacteria were the most in Enterobacteriaceae. Gram-positive bacteria were sensitive to vancomycin and tegacycline, and Gram-negative bacteria were sensitive to imipenem and ceftitan. Staphylococcus and Enterococcus have high resistance to penicillin G. Conclusion the analysis of 1 695 blood culture positive specimens from patients with hematology showed that gram-negative bacteria, especially Escherichia coli, accounted for the majority of blood stream infection. The rate of drug resistance to common antimicrobial agents of isolated bacteria in blood culture was higher, and the most common primary disease was myeloma, and the rate of patients aged 60 to 80 years was the highest. The analysis of the distribution, sensitivity and drug resistance of the isolated bacteria in different primary diseases and age stratified blood cultures is helpful to guide the rational use of drugs in clinic.
【作者单位】：江苏省中医院血液科;
【分类号】：R446.5

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