白血病患者医院感染1 310株病原菌分布及耐药性分析

目的了解白血病患者医院感染病原菌分布及耐药性. 方法对1999年7月～2002年6月全国医院感染监控网医院上报的白血病患者医院感染病原菌进行统计分析. 结果 5 799例次医院感染中,培养出病原菌1 310株,阳性率为22.59%, 其中G-菌占46.34%,G 菌占24.73%,真菌占28.24%;排在前5位的病原菌分别是大肠埃希菌、铜绿假单胞菌、白色念珠菌、金黄色葡萄球菌、表皮葡萄球菌;G-菌对亚胺培南的敏感率>90%,其次为头孢哌酮/舒巴坦,除鲍氏不动杆菌外,其余G-菌敏感率均>85%,G 菌除对万古霉素敏感率>99%,对临床常用的抗菌药物耐药率均>50%. 结论白血病患者医院感染病原菌以G-菌为主,经验性抗菌治疗可选用亚胺培南、头孢哌酮/舒巴坦、万古霉素.

Pathogens Causing Nosocomial Infection in Patients with Leukemia:Their Distribution and Antimicrobial Resistance Analysis of 1 310 Strains

OBJECTIVE To study the distribution and antimicrobial resistance of pathogens causing nosocomial infection (NI) in patients with leukemia. METHODS Pathogens causing NI in patients with leukemia that had been reported to the National Nosocomial Infection System from Jul 1999, to Jun 2002, were analyzed. RESULTS A total of 1 310 strains of pathogens were isolated from 5 779 cases of NI, the isolation rate was 22.59%, 46.34% of which were Gram-negative bacteria, and 24.73% were Gram-positive ones, 28.24% were fungi; the first five isolated bacteria were Escherichia coli, Pseudomonas aeruginosa, Candida albicans, Staphylococcus aureus and ~S. epidermidis; the sensitive rate of bacteria to imipenem was up to more than 90%, the next was cefoperazone/sulbactam, the sensitive rates of Gram-negative bacteria to it was above 85% except Acinetobacter baumannii, the sensitive rate of Gram-positive bacteria to vancomycin was above 99%, and to the commonly used antimicrobial agents in clinic was less than 50%. CONCLUSIONS The main pathogens causing NI in patients with leukemia were Gram-negative bacteria, imipenem, cefoperazone/sulbactam, vancomycin can be chosen as empiric antimicrobial agents for treatment of infection.