恶性肿瘤患者医院感染多药耐药菌的药敏结果及危险因素分析

发布时间：2018-02-07 15:50

  本文关键词： 恶性肿瘤 多药耐药菌 医院感染 药敏性　出处：《中华医院感染学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的深入了解恶性肿瘤患者医院感染多药耐药菌的现状,为降低和控制多药耐药对恶性肿瘤患者造成的伤害提供科学根据。方法选取2014年1月-2016年1月医院收治的1 538例恶性肿瘤患者,筛选出多药耐药菌感染者,对其进行药敏性和危险因素分析。结果 1 538例恶性肿瘤患者中,发生多药耐药菌感染患者共60例,感染率为3.9%;60例发生多药耐药菌感染患者的标本中,分离出耐药菌株98株,以革兰阴性菌为主,67株占68.3%;大肠埃希菌和肺炎克雷伯菌ESBLs菌株检出率为94.7%和86.7%;革兰阳性菌31株占31.6%,MRSA和MRCNS检出率分别为66.7%和72.7%;而耐药菌株对抗菌药物敏感性均较低,革兰阴性菌除外鲍氏不动杆菌和嗜麦芽寡养单胞菌,只对亚胺培南敏感;革兰阳性菌所有菌株对头孢类抗菌药物均有着极强的耐药性,同时还检测出1株肠球菌对万古霉素耐药;患者的年龄、是否合并高血压、糖尿病、是否存在意识障碍、侵入性操作以及住院时间是其发生多重感染的主要危险因素。结论多药耐药菌感染是恶性肿瘤患者死亡的重要原因,甚至是导致其死亡的直接原因;因此对恶性肿瘤患者多药耐药菌感染危险因素和药敏情况进行分析,对降低恶性肿瘤患者的耐药菌感染率以及降低因感染而导致的病死率有着重要意义。
[Abstract]:Objective to investigate the current situation of multidrug resistant bacteria (MDR) in nosocomial infection of malignant tumor patients. In order to reduce and control the harm caused by multidrug resistance to malignant tumor patients, 1 538 patients with malignant tumor were selected from January 2014 to January 2016. Results among the 1 538 patients with malignant tumor, 60 cases were infected with multidrug resistant bacteria, and the infection rate was 3.910%. 98 strains of drug resistant strains were isolated from the specimens of 60 patients with multidrug resistant bacteria infection. The detection rates of Escherichia coli and Klebsiella pneumoniae ESBLs strains were 94.7% and 86.7, and 31 Gram-positive strains were 31.6% and 72.7%, respectively. Except Acinetobacter baumannii and Mycotrophomonas maltophilia, Gram-negative bacteria were only sensitive to imipenem, and all strains of Gram-positive bacteria were highly resistant to cephalosporins. At the same time, a strain of Enterococcus was found to be resistant to vancomycin, the age of the patient, whether he was associated with hypertension, diabetes, and whether there was any disturbance of consciousness. Invasive operation and hospital stay were the main risk factors for multiple infections. Conclusion multidrug resistant bacteria infection is an important cause of death in patients with malignant tumors and even a direct cause of death. Therefore, it is of great significance to analyze the risk factors and drug sensitivity of multidrug resistant bacteria infection in patients with malignant tumor, so as to reduce the infection rate of drug resistant bacteria and the mortality caused by infection.
【作者单位】： 广州市增城区人民医院院感科;广州市增城区人民医院呼吸内科;广州市增城区人民医院普外科;
【基金】：广东省医学科学技术研究基金资助项目(B2015758)
【分类号】：R733
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本文编号：1494743