2015-2017年广东潮汕地区肿瘤专科医院住院肿瘤患者临床分离菌的耐药性分析

目的 了解从2015年1月至2017年12月汕头大学医学院附属肿瘤医院住院肿瘤患者感染病原菌的分布情况及耐药性分析。方法 采用法国生物梅里埃公司全自动鉴定及药敏分析仪Vitek-2 Compat对分离细菌进行鉴定及药敏试验,WHONET5.6软件进行统计。结果 1042株病原菌中G-杆菌580株(55.66%),G+球菌315株(30.23%),真菌106株(10.17%),前5位病原菌分别为大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷伯菌和草绿色链球菌。主要G-杆菌中大肠埃希菌和肺炎克雷伯菌产ESBL率分别为76.72%和32.93%。大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌和鲍曼不动杆菌对亚胺培南的耐药率分别为0.86%、15.71%、1.22%和7.14%。MRSA和MRCNS检出率分别为42.06%和84.78%。肠球菌属对万古霉素、利奈唑胺和替加环素耐药率为0。结论 本院分离的主要病原菌中,大肠埃希菌和肺炎克雷伯菌ESBL检出率高并出现了耐亚胺培南大肠埃希菌和肺炎克雷伯菌。铜绿假单胞菌和鲍曼不动杆菌对亚胺培南和美罗培南也有不同的耐药。临床应采取有效的院感防控措施并合理使用抗菌药物。

Drug resistance analysis of pathogenic bacteria in hospitalized cancer patients from a cancer hospital of Chaoshan,2015-2017

Objective To investigate the distribution and resistance of pathogenic bacteria isolated from hospitalized cancer patients in the cancer hospital of Shantou University Medical College from Jan.2015 to Dec.2017.Methods Bacteria identification and antimicrobial susceptibility testing were conducted by a bio-Merieux automated system and Vitek-2 Compat analyzer,respectively,and then data were analyzed by WHONET5.6 software.Results Among the 1042 bacterial strains,gram-negative organisms,gram-positive cocci and fungus accounted for 55.66%(580/1042),30.23%(315/1042)and 10.17%(106/1042),respectively.E.coil,Pseudomonas aeruginosa,Staphylococcus aureus,Klebsiella pneumoniae and Streptococcus viridians were the top five common strains.The positive rates of ESBLs for E.coil and Klebsiella pneumoniae were 76.72% and 32.93%,respectively.The resistance rates of imipenem for E.coli,Pseudomonas aeruginosa,Klebsiella pneumoniae and Acinetobacter baumannii were 0.86%,15.71%,1.22% and 7.14%,respectively.Detection rates of Methicillin-resistant Staphylococcus aureus(MRSA)and Methicillin-resistant coagulase negative Staphylococci(MRCNS)were 42.06% and 84.78%,respectively.No drug resistance of vancomycin,linezolid and tigecycline was found in Enterococcus.Conclusion The positive rates of ESBLs produced by E.coil and Klebsiella pneumoniae are high in the main pathogenic bacteria from our hospital.Moreover,imipenem-resistant strains occur in E.coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and Acinetobacter baumannii.It is necessary to take effective measures to control hospital infections and improve rational use of antibiotic.