血液科病房临床分离菌株变迁及药物敏感性分析

目的:分析血液科合并感染住院患者菌株菌谱分布和耐药现状,为临床治疗提供参考。方法:收集血液科2007年1月-2009年12月住院患者分离的菌株,细菌药敏试验采用Kirby-Bauer纸片法检测,真菌药敏试验应用ATBFUNGUS药敏条检测。判定结果,并进行统计分析。结果:分离出致病菌432株,其中革兰氏阳性菌(G+菌)占28.0%,革兰氏阴性菌(G-菌)占57.9%,真菌占14.1%。3年间革兰阴性菌比例逐渐减少(63.1%,57.7%,51.9%)。G+菌对万古霉素最敏感,其次为替考拉宁;G-菌对碳青酶烯类最敏感,其次为酶抑制剂复合制剂和阿米卡星;真菌大多对抗真菌药物敏感。结论:对血液科病房感染要及时进行微生物学检查和药敏试验,以合理选择抗生素,降低感染发生率和病死率,减少耐药菌株产生。

Trends and Drug Susceptibility Analysis of Pathogens Isolated from Hematology Ward

Objective To investigate the incidence and antimicrobial resistance of pathogens isolated from hospitalized patients in hematology ward and to provide the evidence for clinical therapy.Methods The pathogen strains were collected from patients from January 2007 to December 2009,the antimicrobial susceptibility was tested by Kirby-Bauer method,the drug sensitivity tests of fungi were performed by ATB Fungus strip.The results were assessed according to CLSI standard and statistically analyzed.Results Totally 432 strains of pathogens were isolated,in which Gram-positive bacteria,Gram-negative bacteria and fungi were accounted for 28.0%,57.9% and 14.1%.The proportion of Gram-negative bacteria was decreasing year by year in the three years,from 63.1%,57.7% to 51.9%.Gram-positive bacteria were mostly sensitive to vancomycin and next to teicoplanin.Gram-negative bacteria were mostly sensitive to carbaenem and next to β-lactamase inhibitor and amikacin sulfate.Fungi were sensitive to mostly anti-fungal drugs.Conclusion The prompt microbiology examination and drug sensitivity tests may be important for rational antibiotics selecting,which woule be helpful for reducing infection and mortality,decreasing the incidence of drug resistant strains.