【摘要】：目的調(diào)查腫瘤患者醫(yī)院感染革蘭陽(yáng)性球菌的分布及其對(duì)常用抗菌藥物的耐藥性,為臨床合理使用抗菌藥物提供依據(jù)。方法回顧性調(diào)查中山大學(xué)腫瘤防治中心2014年172例革蘭陽(yáng)性球菌感染患者臨床資料,所有標(biāo)本均采用法國(guó)生物梅里埃公司VITEK-32微生物鑒定系統(tǒng)進(jìn)行菌種鑒定和耐藥性分析,并采用EXCEL8.0和WHONET5.4軟件對(duì)感染者的基本情況、科室分布、標(biāo)本分布和耐藥性進(jìn)行分析。結(jié)果醫(yī)院感染患者中共分離出172株革蘭陽(yáng)性球菌,主要來(lái)源于咽拭子、痰及引流液;革蘭陽(yáng)性球菌分離率較高的科室為放療科、ICU及胸科;革蘭陽(yáng)性球菌以鏈球菌屬和葡萄球菌屬為主,分別占43.6%和40.1%;鏈球菌屬對(duì)紅霉素及磺胺甲VA唑/甲氧芐啶耐藥率85.0%,對(duì)利奈唑胺和萬(wàn)古霉素敏感率為100.0%;腸球菌屬對(duì)克林霉素及紅霉素耐藥嚴(yán)重,對(duì)替考拉寧和替加環(huán)素敏感率為100.0%,此外發(fā)現(xiàn)1株耐萬(wàn)古霉素腸球菌(VRE);葡萄球菌屬對(duì)青霉素、苯唑西林的耐藥性85.0%,而對(duì)利奈唑胺和替加環(huán)素敏感率為100.0%;耐甲氧西林金黃色葡萄球菌(MRSA)和耐甲氧西林凝固酶陰性葡萄球菌(MRCNS)的檢出率分別為60.0%和89.8%。結(jié)論醫(yī)院感染革蘭陽(yáng)性球菌標(biāo)本主要來(lái)源于呼吸道,以鏈球菌屬和葡萄球菌屬為主;其耐藥性較嚴(yán)重,多藥耐藥明顯,出現(xiàn)了VRE,臨床應(yīng)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.
【作者單位】： 中山大學(xué)腫瘤防治中心醫(yī)院感染管理科;中山醫(yī)學(xué)院臨床醫(yī)學(xué)系;
【基金】：國(guó)家衛(wèi)生計(jì)生委專(zhuān)項(xiàng)基金資助項(xiàng)目(1311200006402)
【分類(lèi)號(hào)】：R446.5

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