梧州地区中老年肿瘤患者医院感染革兰阳性球菌分布及耐药性分析

目的掌握梧州地区中老年肿瘤患者医院感染革兰阳性球菌分布及耐药性。方法对2010年4月至2015年5月136例梧州地区三级医院中老年肿瘤患者医院感染革兰阳性球菌的临床资料进行分析,了解病原菌分布和耐药情况。结果革兰阳性球菌中葡萄球菌属64株(47.06%)、链球菌属45株(33.09%)、肠球菌属27株(19.85%);样本类型主要为咽拭子、痰、引流液和血液标本,共占83.83%;科室来源以ICU、介入科、肿瘤内科最常见,共占71.32%,和同组其他项目比较,差异具有统计学意义(P0.05);耐药性方面,葡萄球菌属对呋喃妥因、替加环素、万古霉素敏感率均为100.00%,对其他抗菌药物的耐药率均在55.00%以上;链球菌属对替考拉宁、万古霉素的敏感性均为100.00%,对其他抗菌药物的耐药率均在57.89%以上;肠球菌属对利奈唑胺的敏感率为100.00%,其中粪肠球菌出现1例(7.69%)对万古霉素耐药,对其他抗菌药物耐药率均在54.55%以上。结论中老年肿瘤患者革兰阳性球菌主要来源于呼吸道,ICU、介入科是感染重灾区,耐药情况严重,存在耐万古霉素粪肠球菌,在临床上要加强抗菌药物管理。

Distribution and drug resistance of gram positive bacteria in hospital infection of elderly patients with cancer in Wuzhou

Objective To master the distribution and drug resistance of gram positive bacteria in hospital infection of elderly cancer patients in Wuzhou area.Methods The clinical data of 136 cases of nosocomial infection with gram positive bacteria were summarized from May 2015 to April 2010 in Wuzhou area,and the distribution and drug resistance of pathogenic bacteria were summarized.Results Gram positive cocci Staphylococcus accounted for 64 strains(47.06％),45 strains of Streptococcus(33.09％),Enterococcus accounted for 27 (19.85 ％) strains of bacteria were gram positive cocci;pathogen mainly from throat swabs,sputum,drainage and blood,83.83％ of the total,Department sources to ICU,Radiology,Medical Oncology,the most common,accounting for 71.32 ％ of all,and the same group of other items had significant difference(P＜0.05);drug resistance,Staphylococcus to nitrofurantoin,tigecycline and vancomycin sensitivity was 100.00 ％,the other resistance was more than 55.00 ％;chain coccus of teicoplanin and vancomycin susceptibility 100.00 ％,more than 57.89 ％ other isolates were resistant to linezolid;Enterococcus faecalis sensitivity was 100.00％,which occurred in 1 cases (7.69％) resistant to vancomycin,other antimicrobial drug resistance was 54.55％ Above.Conclusion Elderly patients with tumors of gram positive cocci mainly come from respiratory tract infection ICU,interventional radiology is the hardest hit,there are serious drug resistance,vancomycin resistant Enterococcus faecalis in clinical,to strengthen the management of antimicrobial agents.