倪苏娇, 宋晓玉, 胥萍瑶. 2012-2016年四川省肿瘤医院肿瘤患者血流感染病原菌种属分布及耐药性分析[J]. 疾病监测, 2018, 33(12): 1058-1062. DOI: 10.3784/j.issn.1003-9961.2018.12.020
引用本文: 倪苏娇, 宋晓玉, 胥萍瑶. 2012-2016年四川省肿瘤医院肿瘤患者血流感染病原菌种属分布及耐药性分析[J]. 疾病监测, 2018, 33(12): 1058-1062. DOI: 10.3784/j.issn.1003-9961.2018.12.020
Sujiao Ni, Xiaoyu Song, Pingyao Xu. Distribution and drug susceptibility of pathogens causing bloodstream infections isolated in Sichuan Cancer Hospital, 2012–2016[J]. Disease Surveillance, 2018, 33(12): 1058-1062. DOI: 10.3784/j.issn.1003-9961.2018.12.020
Citation: Sujiao Ni, Xiaoyu Song, Pingyao Xu. Distribution and drug susceptibility of pathogens causing bloodstream infections isolated in Sichuan Cancer Hospital, 2012–2016[J]. Disease Surveillance, 2018, 33(12): 1058-1062. DOI: 10.3784/j.issn.1003-9961.2018.12.020

2012-2016年四川省肿瘤医院肿瘤患者血流感染病原菌种属分布及耐药性分析

Distribution and drug susceptibility of pathogens causing bloodstream infections isolated in Sichuan Cancer Hospital, 2012–2016

  • 摘要:
    目的 了解2012 — 2016年四川省肿瘤医院肿瘤患者血流感染病原菌的分布及其耐药特征,为临床合理使用抗菌药物提供依据。
    方法 统计肿瘤患者血培养中分离病原菌种类及对常见临床药物的耐药特征,依据美国临床和实验室标准协会2016年标准,采用WHONET 5.6软件进行数据统计分析。
    结果 通过血培养共分离到病原菌603株,其中革兰阳性球菌、革兰阴性杆菌和真菌分别为165、434和4株;各肿瘤患者以宫颈癌患者分离率最高。 大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、凝固酶阴性葡萄球菌和阴沟肠杆菌分离率较高,分别为34.33%、13.27%、9.29%、6.80%和4.98%。 金黄色葡萄球菌和凝固酶阴性葡萄球菌中甲氧西林耐药株的检出率分别为12.50%和73.17%。 肠杆菌科细菌对碳青霉烯类抗生素高度敏感,大多数细菌耐药率均低于5.00%,非发酵菌对碳青霉烯类耐药率较高,鲍曼不动杆菌对亚胺培南和美罗培南的耐药率甚至达到了80.00%。
    结论 肿瘤医院患者血培养中分离的细菌以肠杆菌科为主,各分离菌耐药情况差异较大,鲍曼不动杆菌属对碳青霉烯的耐药情况较为严峻,临床应根据不同肿瘤及分离细菌药敏结果合理选择抗生素治疗。

     

    Abstract:
    Objective To investigate the distribution and drug susceptibility of pathogens causing bloodstream infection isolated from blood samples of cancer patients in Sichuan Cancer Hospital from January 2012 to December 2016 and provide evidence for the rational use of antibiotics.
    Methods The drug susceptibility of the pathogen strains isolated from the cancer patients were analyzed with software WHONET 5.6 according to the breakpoints of Clinical and Laboratory Standards Institute in 2016.
    Results A total of 603 pathogen strains were isolated from blood samples of the cancer patients, including 165 gram positive cocci strains, 434 gram negative bacilli strains and 4 fungi strains, respectively. In the all cancer patients, the pathogen isolation rate was highest in cervical carcinoma patients, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, coagulase negative Staphylococcus and Enterobacter cloacae were the most common pathogens isolated, accounting for 34.33%, 13.27%, 9.29%, 6.80% and 4.98%, respectively. Methicillin resistant strains accounted for 12.50% and 73.17%, respectively, in S. aureus and coagulase negative Staphylococcus isolates. The strains of Enterobacteriaceae were still highly sensitive to carbapenems, less than 5.00% of these strains were resistant to carbapenems. In contrast, Acinetobacter baumannii was highly resistant to carbapenems, and about 80.00% of A. baumannii strains were resistant to imipenem and meropenem, respectively.
    Conclusion Enterobacteriaceae was the main pathogens isolated from the blood samples of the cancer patients. Their drug susceptibilities varied. The resistance of A. baumannii to carbapenem was serious. Therefore, it is necessary to use antibiotics rationally according to the type of cancer and related drug susceptibility test results.

     

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