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目的分析恶性肿瘤患者病原菌分布及耐药性趋势,为临床预防控制和治疗其医院感染提供实验室依据。方法收集本院2011年-2015年从恶性肿瘤患者分离出的病原菌697株,纸片扩散法(K-B)进行药敏试验,WHONET5.6软件统计分析资料。结果 697株标本中前5位病原菌分别为肺炎克雷伯菌133株(19.1%)、大肠埃希菌108株(15.5%)、铜绿假单胞菌72株(10.3%)、金黄色葡萄球菌62株(8.9%)、鲍曼不动杆菌43株(6.2%)。革兰阴性菌占64.4%,革兰阳性菌占27.8%,真菌占7.7%。MRSA和MRCNS检出率分别为40.3%和72.5%。大肠埃希菌和肺炎克雷伯菌中ESBLs检出率分别为64.8%和30.1%,检出耐碳青霉烯类肺炎克雷伯菌(4株)和大肠埃希菌(1株)。鲍曼不动杆菌对亚胺培南和美罗培南耐药率分别16.3%和19.4%;铜绿假单胞菌对亚胺培南和美罗培南耐药率分别为12.5%和9.7%。真菌(1-3)-β-D-葡聚糖阳性率为62.3%。结论恶性肿瘤患者病原菌分布和耐药性变化有自己的特点,已监测到耐碳青霉烯类肠杆菌科细菌。
Objective To analyze the distribution of pathogens in patients with malignant tumors and trends of drug resistance, and provide laboratory evidence for clinical prevention and control and treatment of their nosocomial infections. Methods A total of 697 pathogenic bacteria isolated from malignant tumor patients in our hospital from 2011 to 2015 were collected. Susceptibility test was performed by disk diffusion method (K-B) and data were analyzed by software WHONET5.6. Results Among the 697 specimens, the top five pathogenic bacteria were Klebsiella pneumoniae (133.1%), Escherichia coli (108.5%), Pseudomonas aeruginosa 72 strains (10.3%), Staphylococcus aureus 62 (8.9%) and Acinetobacter baumannii 43 (6.2%). Gram-negative bacteria accounted for 64.4%, Gram-positive bacteria accounted for 27.8%, fungi accounted for 7.7%. The detection rates of MRSA and MRCNS were 40.3% and 72.5% respectively. The detection rates of ESBLs in Escherichia coli and Klebsiella pneumoniae were 64.8% and 30.1%, respectively. Klebsiella pneumoniae (4 strains) and Escherichia coli (1 strain) were detected. The rates of resistance to imipenem and meropenem in Acinetobacter baumannii were 16.3% and 19.4%, respectively. The rates of resistance of P. aeruginosa to imipenem and meropenem were 12.5% and 9.7%, respectively. The positive rate of fungi (1-3) -β-D-glucan was 62.3%. Conclusion The distribution of pathogenic bacteria in patients with malignant tumors and drug resistance changes have their own characteristics, has been tested against carbapenem-resistant Enterobacteriaceae bacteria.