本文關(guān)鍵詞： 惡性腫瘤 多藥耐藥菌 醫(yī)院感染 藥敏性　出處：《中華醫(yī)院感染學(xué)雜志》2017年10期 　論文類型：期刊論文

【摘要】：目的深入了解惡性腫瘤患者醫(yī)院感染多藥耐藥菌的現(xiàn)狀,為降低和控制多藥耐藥對惡性腫瘤患者造成的傷害提供科學(xué)根據(jù)。方法選取2014年1月-2016年1月醫(yī)院收治的1 538例惡性腫瘤患者,篩選出多藥耐藥菌感染者,對其進(jìn)行藥敏性和危險(xiǎn)因素分析。結(jié)果 1 538例惡性腫瘤患者中,發(fā)生多藥耐藥菌感染患者共60例,感染率為3.9%;60例發(fā)生多藥耐藥菌感染患者的標(biāo)本中,分離出耐藥菌株98株,以革蘭陰性菌為主,67株占68.3%;大腸埃希菌和肺炎克雷伯菌ESBLs菌株檢出率為94.7%和86.7%;革蘭陽性菌31株占31.6%,MRSA和MRCNS檢出率分別為66.7%和72.7%;而耐藥菌株對抗菌藥物敏感性均較低,革蘭陰性菌除外鮑氏不動(dòng)桿菌和嗜麥芽寡養(yǎng)單胞菌,只對亞胺培南敏感;革蘭陽性菌所有菌株對頭孢類抗菌藥物均有著極強(qiáng)的耐藥性,同時(shí)還檢測出1株腸球菌對萬古霉素耐藥;患者的年齡、是否合并高血壓、糖尿病、是否存在意識(shí)障礙、侵入性操作以及住院時(shí)間是其發(fā)生多重感染的主要危險(xiǎn)因素。結(jié)論多藥耐藥菌感染是惡性腫瘤患者死亡的重要原因,甚至是導(dǎo)致其死亡的直接原因;因此對惡性腫瘤患者多藥耐藥菌感染危險(xiǎn)因素和藥敏情況進(jìn)行分析,對降低惡性腫瘤患者的耐藥菌感染率以及降低因感染而導(dǎo)致的病死率有著重要意義。
[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.
【作者單位】： 廣州市增城區(qū)人民醫(yī)院院感科;廣州市增城區(qū)人民醫(yī)院呼吸內(nèi)科;廣州市增城區(qū)人民醫(yī)院普外科;
【基金】：廣東省醫(yī)學(xué)科學(xué)技術(shù)研究基金資助項(xiàng)目(B2015758)
【分類號(hào)】：R733
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本文編號(hào)：1494743