肿瘤患者重症感染时病原菌分布及耐药性分析

发布时间：2018-04-12 15:12

本文选题：肿瘤 + 重症感染　；参考：《中华医院感染学杂志》2017年18期

【摘要】：目的探究肿瘤患者发生重症感染时,病原菌的分布及耐药性情况。方法对2014-2016年入住中山大学肿瘤防治中心重症医学科(ICU)的149名重症感染患者送检的病原学标本,分离培养的病原菌及药物敏感测定数据进行回顾性分析。结果 149名重症感染患者病原学送检标本共培养出271株病原菌,其中革兰阴性菌137株,占50.55%;革兰阳性菌91株,占33.58%;真菌43株,占15.87%;革兰阴性菌以铜绿假单胞菌、嗜麦芽寡养单胞菌和大肠埃希菌为主;革兰阳性菌主要以表皮葡萄球菌和缓症链球菌为主。葡萄球菌属对青霉素、红霉素、阿奇霉素、克拉霉素、环丙沙星等常用抗生药物的耐药率较高,达到并超过60%,铜绿假单胞菌对氨苄西林/舒巴坦、磺胺甲VA唑/甲氧苄啶、呋喃妥因等耐药率高,达90%以上,对亚胺培南的耐药率为31.3%,而对氟喹诺酮类药物如环丙沙星、左氧氟沙星及哌拉西林/他唑巴坦的敏感性相对较高。结论对于合并重症感染的肿瘤患者,应依据病情、耐药性选择较为敏感、广谱抗菌药物进行联合治疗。
[Abstract]:Objective to explore the tumor patients with severe infection, drug resistance and distribution of pathogens. For 2014-2016 years in Zhongshan University cancer prevention center ICU (ICU) study from 149 specimens of patients with severe infection of the pathogen, isolation of pathogenic bacteria and drug sensitivity test data were analyzed retrospectively. Results 149 patients with severe infection the pathogeny of specimens 271 strains of fungi were isolated, including 137 strains of gram negative bacteria, accounting for 50.55%; 91 strains of gram positive bacteria, accounting for 33.58%; 43 strains of fungi, accounting for 15.87%; gram negative bacteria were Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Escherichia coli; gram positive bacteria were mainly Staphylococcus epidermidis and streptococcus disease. Staphylococcus to penicillin, erythromycin, azithromycin, clarithromycin, ciprofloxacin and other antibiotics commonly used drug resistance rate, and reached more than 60%, copper Pseudomonas aeruginosa to ampicillin / sulbactam, sulfamethoxazole / trimethoprim VA triazole, nitrofurantoin resistance rate is high, more than 90%, to imipenem was 31.3%, while the fluoroquinolones such as ciprofloxacin, levofloxacin and piperacillin / tazobactam sensitivity is relatively high. Conclusion for cancer patients complicated with severe infection, should choose according to the illness, drug resistance is more sensitive to antibiotic combination therapy.

【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;R73

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