血液肿瘤患者医院获得性感染细菌病原学研究

目的 探讨血液肿瘤患者化疗后粒细胞缺乏期，医院感染的细菌病原学特点及体外对抗生素的敏感性，为临床抗生素应用提供参考。方法 化疗后粒细胞缺乏期出现感染性发热患者，在应用抗生素前留取血，痰、尿及分泌物标本，体外分离细菌菌株并测定对抗生素的敏感性。结果 医院感染细菌以G^-杆菌多见，大肠埃希菌，肺炎克雷伯菌，铜绿假单胞菌是最常见的致病菌，鲍曼不动杆菌有逐年增加的趋势；G^ 球菌感染主要为肠球菌属；体外药敏试验显示耐药菌株近年来有增加趋势，大多数G^-杆菌对半合成青霉素耐药，5%左右肠球菌对万古霉素耐药。结论 在化疗后粒细胞缺乏的患者医院感染的细菌主要为内源性菌，耐药菌株增加，其原因与大量广谱抗生素应用及医院交叉感染有关。

Etiology of Nosocomial Infection and Sensitivity to Antibiotics in vitro in Patients with Hematological Malignancies

OBJECTIVE To determine the bacterial distribution of nosocomial infection and sensitivity to antibiotics in vitro in neutropenic patients receiving chemotherapy for hematological malignancies.METHODS The sample was taken from blood,urine and sputum in patients with febrile neutropenia. Bacteria were isolated and determined in vitro.RESULTS Gram negative bacteria were the most common cause of nosocomial infection.E.coli,Klebsiella,Pseudomonas aeruginosa account for the most of G - bacterial infection and most are resistant to broad spectrum penicillin. Enterococcus is the most common cause of G + bacterial infection. Vacomycin resistant enterococci were found in about 5% of strains isolated.CONCLUSIONS Endogenous bacteria are main cause of nosocomial infection in patients with hematological malignancies.Gram negative bacteria were the common cause. Strains resistant to antimicrobial agents are increasing.