摘要
目的了解医院血液科病房病原菌的流行分布情况及耐药现状。方法药敏试验采用K-B法，采用WHONET 5.4软件进行数据分析。结果共分离致病菌623株，革兰阴性菌占55.7%，革兰阳性菌占33.3%，真菌占11.0%。标本主要来源于血液（40.9%）、痰液（26.0%）和尿液（14.0%）。前3位细菌为大肠埃希菌（15.1%）、凝固酶阴性葡萄球菌（15.1%）和肺炎克雷伯菌（10.1%）。大肠埃希菌和肺炎克雷伯菌超广谱β-内酰胺酶阳性率为62.0%和46.8%，对美罗培南、亚胺培南敏感性〉95%；铜绿假单胞菌对左氧氟沙星、亚胺培南、美罗培南、头孢哌酮/舒巴坦钠、哌拉西林/他唑巴坦耐药性均〈20%，嗜麦芽窄食单胞菌对左氧氟沙星、复方新诺明、米诺环素敏感性〉85%。凝固酶阴性葡萄球菌及金黄色葡萄球菌中耐甲氧西林凝固酶阴性葡萄球菌76.6%、耐甲氧西林金黄色葡萄菌34.6%，出现替考拉宁耐药株。肠球菌属对替考拉宁及万古霉素的敏感性分别为84.1%和70.3%，分离到替考拉宁及万古霉素耐药菌株。结论血液科病房致病菌以革兰阴性杆菌为主，革兰阴性菌对常用经验性抗菌药保持了较好的敏感性，革兰阳性菌耐药性较前加重。
Objective To investigate the distribution and antibiotic resistance of infection pathogens isolated from hematology ward . Methods Bacterial susceptibility test was carried out byK-B method. Data were analyzed by WHONET 5.4 software. Results A total of 667 pathogens were isolated and collected, including gram-negative bacilli （55.7%）, gram-positive cocci （33.3%） and fungi （11.0%）. The dominant source of pathogens was blood （40. 9% ） , sputum （26. 0% ） and urine （ 14.0% ）. The top 3 pathogens were Escherichia coli （ 15.1% ）, Coagulase negative Staphylococcus （15.1%） and Klebsiella pneumoniae （10. 1% ）. About 46. 8 % of Klebsiella pneumoniae and 62. 0% of Escherichia coli produced extended spectrum β-1aetamases. The sensitive rates of Klebsiella pneumoni- ae and Escherichia coli to imipenem and meropenem were both more than 95%. The resistance rates of Pseudomonas aeruginosa to levofloxacin, imipenem, meropenem, Cefoperazone/sulbactam, piperacillin/ tazobactam were lower than 20%. More than 85% strains of Stenotrophymonas maltophilia were suscepti- ble to levofloxacin, cotrimoxazole and minocycline. The prevalence of methicillinresis tant coagulase-inegative staphylococci and methicillin resistant staphylococcus aurreus were 34. 6% and 76.6% in Coagu- lase negative staphylococcus and Staphylococcus aureus, and strain resistant to teicoplanin was isolated. The susceptibility of Enterococcus spp. to teicoplanin and vancomycin were 84. 1% and 70. 3%, respectively. Gram-positive cocci resistant strains to teicoplanin and vancomycin were isolated. Conclusions Gram-negative bacilli keep the most prevalence pathogens in the hematology ward and high susceptibility to empirical antimicrobial agents. But the antibiotic resistance to glycopeptide antibiotics was getting worsen for the major gram-positive cocci.
作者
黄巾津
陈中举
黄丽芳
董培源
孟凡凯
Huang Jinjin;Chen Zhongju;Huang Lifang;Dong Peiyuan;Meng Fankai(Tongfi Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Chin)
出处
《中国实用医刊》
2018年第7期10-13,共4页
Chinese Journal of Practical Medicine
关键词
血液病
病原菌
耐药性
Hematologic diseases
Infection pathogens
Antibiotic resistance
