恶性肿瘤患者的医院感染及其对策

目的 :调查恶性肿瘤患者医院感染的部位、病原菌和药敏 ,并探讨其防治措施。方法 :调查2 0 0 0年 1月 - 2 0 0 1年 12月在肿瘤科住院的恶性肿瘤合并医院感染的 148例患者的感染部位、病原菌和药敏 ,作回顾性综合分析 ,并对医院感染的防治作初步探讨。结果 :本组医院感染主要部位在下呼吸道 ,占 73 7% ;其次为泌尿道 ,占 11 0 %。 148例患者中共检出致病菌株 186株 ,革兰氏阴性菌占 96株(5 1 6% ) ,其中前 3位是肺炎克雷伯菌 19株 (10 2 % ) ,铜绿色假单胞菌 19株 (10 2 % ) ,鲍曼不动杆菌17株 (9 1% )。真菌 60株 (32 3% ) ;革兰氏阳性菌 30株 (16 1% )。 6例为重复感染 ,有 2 8例是几种混合细菌感染。检出阳性病原体中占前 3位的革兰氏阴性菌药敏结果与经验治疗的药敏结果相仿。结论 :恶性肿瘤患者常由条件致病菌引起自身感染 ,以革兰氏阴性菌及真菌为主。其临床症状缺乏特征性 ,故应高度警惕 ,及时诊断 ,尽早开始经验治疗 ,一旦检出致病菌 ,应选用针对性强的高活性、低毒杀菌剂 ,避免滥用抗生素。同时加强预防措施也至关重要

Malignant Tumour Patients'Nosocomial Infection and Countermeasures

Objective To investigate the positions,pathogens,drug-sensitive experiment in malignant tumour patients with nosocomial infections and discuss the prevention and treatment.Methods From 2000 to 2001,there were 148 patients with malignant tumour who acquired nosocomial infections in Department of Oncology.Its infect positions,pathogens,drug-sensitive experiment were investigated,synthetically retrospective analysis was made and the prevention and treatment on nosocomial infections were preliminarily discussed.Results The main position was the lower respiratory tract which accounted for 73.7% in this group of nosocomial infectious patients;The second was urinary tract,accounting for 11.0%.One hundred and eighty-six bacteric strains were checked out among 148 patients.Gram-negative bacilli accounted for 51.6% (96 strains),and among them,the top three were the pneumonic Klebsiella's germ which accounted for 10.2% (19 strains),pseudomonas aeruginnosa accounted for 10.2% (19 strains) and Baumanii's bacteria accounted for 9.1% (17 strains).There were 60 fungi strains (32.3%) and Gram-positive-bacilli accounted for 16.1% (30 strains).Some of patients had superinfection and mixed-bacterial-infection.In the top three positive pathogens,the result of Gram-negative bacilli drug-sensitive experiment accorded with that of the experiential treatment.Conclusions Self-infections were generally caused by conditional pathogens which included fungi and Gram-negative bacilli.The self-infections should be noticed and diagnosed for experimential treatment in time because nosocomail infections often lacked characteristic clinical symptoms.After checking out the pathogens,strong high active and low-toxicity bactericides should be selected and abusing antibiotic be avoideds.It isessential to strengthen the precautionary measures at the same time.