血液科病房感染致病菌分布特点及药物敏感性分析

为了了解本院近两年血液科病房致病菌临床分布特点及其对抗生素的药物敏感性，按常规方法从标本中对致病菌进行分离和培养。细菌药敏试验采用Kirby-Bauer法，真菌药敏试验应用ATBFUNGUS药敏条。结果显示，从所有送检标本中分离出致病菌共102株，其中革兰阳性菌(G 菌)占42．2％，革兰阴性菌(G-菌)占34．3％，真菌占3．5％。58．8％致病菌分离自恶性血液病患者，27．5％来自不明原因的发热(FUO)患者。此外，在患者处于粒细胞缺乏或者白细胞减少时分离出的致病菌就占到51．0％。分离出的真菌大多对抗真菌药物敏感，而G 菌对万古霉素(vancomycin)最敏感，G-菌对亚胺培南(imipenem)最敏感，多数细菌呈多重耐药性。结论：血液科病房感染与患者自身抵抗力低下、白细胞减少或粒细胞缺乏、肿瘤负荷过重等多种因素有关。临床上及时进行微生物学检查和药敏试验，对合理选择抗生素、降低感染发生率和死亡率以及减少耐药菌株产生均有重要价值。

Analysis of the Distribution Characteristics and Drug Sensitivity of Infection Pathogens in Hematology Department Ward

The objective of this study was to investigate clinical distribution characteristics and drug sensitivity of infection pathogens in hematology department wards of our hospital during recent two years. The isolation and cultivation of pathogens from samples were performed by routine methods. Drug sensitivity tests of bacteria were performed by Kirby Bauer method. Drug sensitivity tests of fungi were performed by ATBFUNGUS Drug sensitivity strips. The results showed that 102 strains of pathogens were isolated from all detected samples. The composition ratio of Gram positive bacteria,Gram negative bacteria and fungi was 42.2%, 34.3%, 3.5%, respectively. 58.8% of pathogens were isolated from samples of malignant hematopathy patients. 27.5% were isolated from samples of the patients with fever of unknown origin (FUO). 51.0% of pathogens were isolated from samples of the patients who suffered from agranulocytosis or leucocytopenia. Isolated fungi were mostly sensitive to anti fungal drugs. G bacteria were most sensitive to vancomycin. G- bacteria were most sensitive to imipenem. Most bacteria were resistant to multiple antibiotics. It is concluded that the infection in hematology department wards was related with many conditions, such as weakened resistance of patients, leucocytopenia or agranulocytosis, tumor loading, etc. The prompt microbiologcal examination and drug sensitivity tests are important to rationally select antibiotics, reduce infection incidence and mortality rate, and decrease the occurence of drug resistant strains.