恶性肿瘤患者铜绿假单胞菌血流感染的临床分析

  目的   分析恶性肿瘤患者合并铜绿假单胞菌血流感染的相关危险因素及耐药性情况。   方法   回顾性分析天津医科大学肿瘤医院2010年1月至2012年12月30例合并铜绿假单胞菌血流感染及90例无铜绿假单胞菌血流感染的恶性肿瘤患者的临床资料；采用Whonet 5.6软件和SPSS 19.0对数据进行统计学分析。   结果   感染组患者男20例，女10例，平均年龄（60.9±11.2）岁；对照组患者男60例，女30例，平均年龄（51.3±15.9）岁；多因素Logistic回归分析显示住院次数、合并其他部位感染和应用≥2种类型抗生素为恶性肿瘤患者合并铜绿假单胞菌血流感染的独立危险因素（P < 0.05）。铜绿假单胞菌对碳青霉烯类、头孢他啶、头孢吡肟、氨基糖苷类和喹诺酮类敏感性较高（>80%）。合并铜绿假单胞菌血流感染的恶性肿瘤患者的死亡率为60%。   结论   恶性肿瘤患者合并铜绿假单胞菌血流感染死亡率高，在临床工作中必须采取综合防治的措施，减少铜绿假单胞菌血流感染的发生。  

Clinical analysis of cancer patients with Pseudomonas aeruginosa bloodstream infections

  Objective   To analyze risk factors of cancer patients with Pseudomonas aeruginosa bloodstream infections and drug resistance.   Methods   Clinical data of 30 cancer patients with P. aeruginosa bloodstream infection and 90 without infection who were admitted in the Tianjin Medical University Cancer Institute and Hospital between January 2010 and December 2012 were retrospectively analyzed. Whonet 5.6 and SPSS19.0 software were used for statistical analysis of the data.   Results   The infection group consisted of 20 male and 10 female patients with a mean age of 60.9±11.2 years. The control group consisted of 60 males and 30 females with a mean age of 51.3 ± 15.9 years. Multivariate logistic regression analysis showed that the number of hospitalization, combined with infection of other sites, and more than two types of antibiotics were independent risk factors of cancer patients with P. aeruginosa bloodstream infections. P. aeruginosa showed high sensitivity(>80%) to carbapenems, ceftazidime, cefepime, aminoglycosides, and fluoroquinolones. The mortality rate of cancer patients with P. aeruginosa bloodstream infections was 60%.   Conclusion   Cancer patients with P. aeruginosa bloodstream infections have high mortality. Therefore, comprehensive prevention and control measures must be implemented in clinical practice to reduce P. aeruginosa bloodstream infections.