血液病住院患者血培养分离菌的分布及耐药性分析

发布时间：2018-05-07 20:07

本文选题：血液病 + 血培养　；参考：《中国感染与化疗杂志》2017年03期

【摘要】：目的了解血液科病房血培养分离病原菌的分布及其耐药现状。方法药敏试验采用纸片扩散法。用WHONET5.6软件进行数据分析。结果共分离出521株病原微生物,其中革兰阴性菌47.2%,革兰阳性菌45.7%,真菌7.1%。主要为凝固酶阴性葡萄球菌154株、大肠埃希菌88株、肺炎克雷伯菌51株、铜绿假单胞菌39株和肠球菌属34株。肺炎克雷伯菌和大肠埃希菌超广谱β内酰胺酶(ESBL)阳性率分别为40.4%和63.4%。大肠埃希菌对美罗培南、亚胺培南敏感率90%,对哌拉西林-他唑巴坦敏感率70%;肺炎克雷伯菌对美罗培南、亚胺培南敏感率85%,对左氧氟沙星、哌拉西林-他唑巴坦的头孢哌酮-舒巴坦的敏感率70%;铜绿假单胞菌对环丙沙星、妥布霉素敏感率90%,对左氧氟沙星、美罗培南、亚胺培南、哌拉西林-他唑巴坦、头孢吡肟、头孢哌酮-舒巴坦的敏感率均70%。凝固酶阴性葡萄球菌和肠球菌属对利奈唑胺、替考拉宁敏感率均90%。MRCNS检出率为82.5%。检出耐碳青霉烯类大肠埃希菌3株、肺炎克雷伯菌4株和耐万古霉素肠球菌8株。结论革兰阴性菌是血液病患者血流感染主要致病菌,常见革兰阴性菌对哌拉西林-他唑巴坦、美罗培南、亚胺培南较敏感,革兰阳性菌对利奈唑胺、替考拉宁较为敏感。这对临床经验性用药具有很大指导作用。
[Abstract]:Objective to understand the distribution and drug resistance of pathogenic bacteria isolated from blood culture in the Department of Hematology. Method the paper diffusion method was used in the drug sensitivity test. The data were analyzed with WHONET5.6 software. The results were divided into 521 pathogenic microbes, including gram-negative bacteria 47.2%, Gram-positive bacteria 45.7%, and 154 true coagulase negative Staphylococcus strains. 88 strains of Escherichia coli, 51 Klebsiella pneumoniae, 39 Pseudomonas aeruginosa and 34 enterococci, Klebsiella pneumoniae and Escherichia coli (ESBL) were positive for 40.4% and 63.4%. Escherichia coli to meropenem, imipenem sensitivity 90%, piperacillin tazobactam sensitivity 70%; klebber pneumonia The sensitivity of the bacteria to meropenem and imipenem was 85%, and 70% of levofloxacin, piperacillin and tazobactam was sensitive to cefoperazone sulbactam, and Pseudomonas aeruginosa was sensitive to ciprofloxacin, tobramycin, 90%, levofloxacin, meropenem, imipenem, piperacillin tazobactam, cefpipime, cefoperazone and sulbactam. The susceptibility rates of 70%. coagulase negative Staphylococcus and Enterococcus to linezolid, teicoplanin sensitivity 90%.MRCNS detection rate were 82.5%., 4 strains of Klebsiella pneumoniae and 8 strains of vancomycin resistant Enterococcus. Conclusion Gram-negative bacteria are the main pathogenic bacteria and common leather in blood flow disease patients. Blue negative bacteria are sensitive to piperacillin - tazobactam, meropenem and imipenem. Gram-positive bacteria are more sensitive to linezolid and teicoplanin. This has a great guiding role for clinical empiric drug use.

【作者单位】：华中科技大学同济医学院附属同济医院检验科;华中科技大学同济医学院附属同济医院血液内科;
【分类号】：R446.5;R55

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