【摘要】：目的:調(diào)查某院腫瘤患者多重耐藥菌感染特點、病原菌分布及耐藥性,為臨床合理應(yīng)用抗菌藥物,預(yù)防和控制多重耐藥菌感染提供參考依據(jù)。方法:對某院2014年收治腫瘤患者的多重耐藥菌感染情況進行回顧性調(diào)查分析。結(jié)果:調(diào)查期間發(fā)生腫瘤患者多重耐藥菌感染492例,占醫(yī)院感染的10.87%,男女比例為1.83∶1,原發(fā)腫瘤肺癌居首。其中,62.81%的患者接受過手術(shù),45.04%的患者接受過化療,感染部位以呼吸道、手術(shù)切口和泌尿道為主。分離出革蘭陰性菌426株,革蘭陽性菌66株,超廣譜β-內(nèi)酰胺酶(ESBLs)菌株分離率為86.62%,耐甲氧西林葡萄球菌(MRS)檢出率為91.38%。提示產(chǎn)ESBLs腸桿菌耐藥嚴重,僅對阿米卡星及碳青霉烯類藥物顯示出較好的敏感性;鮑曼不動桿菌對頭孢哌酮舒巴坦敏感率最高,為29.41%。未發(fā)現(xiàn)耐萬古霉素葡萄球菌,但檢出1例耐萬古霉素屎腸球菌。結(jié)論:腫瘤患者是多重耐藥菌感染的高發(fā)群體,且細菌耐藥性較高,臨床應(yīng)予以重視,加強抗菌藥物合理使用,積極控制病原菌的耐藥性。
[Abstract]:Objective: to investigate the characteristics, distribution and drug resistance of multidrug resistant bacteria (MDR) in cancer patients in a hospital, and to provide a reference for the rational use of antimicrobial agents and the prevention and control of MDR infection. Methods: the multidrug-resistant bacteria infection in tumor patients admitted in a hospital in 2014 was analyzed retrospectively. Results: 492 cases (10.87%) of nosocomial infection occurred multidrug resistant bacteria infection in cancer patients. The ratio of male and female was 1.83: 1. Primary tumor lung cancer was the most common. 62.81% of the patients had undergone operation and 45.04% had received chemotherapy. Respiratory tract, surgical incision and urinary tract were the main sites of infection. 426 strains of Gram-negative bacteria, 66 strains of Gram-positive bacteria, 86.62% of extended-spectrum 尾 -lactamase (ESBLs) strains were isolated, and 91.38% of methicillin-resistant staphylococcus (MRS) were detected. The results suggest that Enterobacter ESBLs is highly resistant to amikacin and carbapenem, and Acinetobacter baumannii is the most sensitive to cefoperazone sulbactam with 29.41. No vancomycin resistant staphylococcus was found, but one case of vancomycin resistant Enterococcus faecium was detected. Conclusion: tumor patients are a high incidence group of multidrug resistant bacteria infection, and bacteria resistance is high, clinical attention should be paid to strengthen the rational use of antimicrobial agents, and actively control the drug resistance of pathogens.
【作者單位】： 哈爾濱醫(yī)科大學(xué)附屬腫瘤醫(yī)院藥學(xué)部;
【分類號】：R446.5
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本文編號：2227137