肿瘤患者临床常见病原菌的分布及耐药特征

目的探讨肿瘤患者临床常见病原菌的分布及耐药特征. 方法通过对2000年1月～2001年12月肿瘤住院患者临床各类标本中分离的1 280株病原菌,并按美国国家临床实验室标准化委员会(NCCLS)标准进行药敏试验. 结果肿瘤患者感染病原菌前5位依次为铜绿假单胞菌(21.5%)、大肠埃希菌(19.0%)、不动杆菌属(10.5%)、克雷伯菌属(10.2%)、肠杆菌属(10.1%);甲氧西林耐药株分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的71.8%、80.6%,未发现万古霉素耐药株;大肠埃希菌和肺炎克雷伯菌ESBLs的检出率分别为34.6%和35.6%,产ESBLs菌株对抗菌药物的敏感性显著降低. 结论肿瘤患者临床常见病原菌主要是革兰阴性杆菌,且对常用抗菌药物耐药率较高,并有多重耐药,应加强细菌耐药性监测工作,合理使用抗生素,降低肿瘤患者医院感染的发生率.

Commonly Encountered Pathogens in Clinical Tumor Patients:Characteristics of Their Distribution and Drug Resistance

OBJECTIVE To investigate the commonly encountered pathogens and characteristics of their distribution and drug resistance in tumor patients. METHODS A total of 1 280 strains of pathogens were separated from all kinds of clinical specimen.The drug sensitivity test was detected by the standard of NCCLS and analyzed with NETS of WHO. RESULTS The first five kinds of pathogens in our hospital were Pseudomonas aeruginosa (21 5%), Escherichia coli (19 0%), Acinetobacter spp (10 5%), Klebsiella spp (10 2%), and Enterobacter spp. (10 1%). There were 71 8% strains of Staphylococcus aureus and 80 6% of meticillin resistant coagulase negative staphylococcus, respectively. No vancomycin resistant staphylococci were found. The detection rate of ESBLs producing E. coli and Klebsiella spp was 34 6%and 35 6%,respectively. The sensitivity against antimicrobial drugs was significant lower than that of ESBLs non producing ones. CONCLUSIONS The commonly encountered pathogens are G - bacilli. They have a high bacterial resistance against the common antimicrobial drugs. We should discern the mechanism and characteristic of all kinds of pathogens so as to best monitor the bacterial resistance.