论文部分内容阅读
目的检测血液肿瘤患儿化疗后血液培养产超广谱β-内酰胺酶(ESBLs)病原菌,并进行耐药性分析。方法对216例血液肿瘤患儿化疗后进行血培养、菌株鉴定及药敏试验,结果按美国临床实验室标准化委员会(NCCLS)标准判读。结果大肠埃希菌及肺炎克雷伯杆菌产ESBLs菌株检出情况2370例次血培养中,分别检出大肠埃希菌及肺炎克雷伯杆菌68例和26例,两菌检出阳性率3.97%;其中产ESBLs菌株分别为30例、15例,产ESBLs病原菌总检出率为48.78%(45/94)。产酶菌株对常用抗生素的敏感性与未产酶菌有明显区别,产酶菌及非产酶菌对哌拉西林/他唑巴坦及阿米卡星呈高敏感性,对头孢类抗生素的耐药性则呈现个性化趋势。结论恶性血液肿瘤化疗后感染患儿产ESBLs病原菌检出率较高;产ESBLs细菌对常规抗生素耐药性高,参照病原菌培养及药物敏感性试验进行抗菌治疗,能够极大地避免治疗失败。
Objective To detect the pathogenic bacteria of extended-spectrum β-lactamase (ESBLs) in blood after chemotherapy in children with hematological malignancies and to analyze the drug resistance. Methods Blood culture, strain identification and drug sensitivity test were performed in 216 children with hematological malignancies after chemotherapy. The results were interpreted according to the criteria of the American Clinical Laboratory Standards Committee (NCCLS). Results Detection of Escherichia coli and Klebsiella pneumoniae producing ESBLs strains In 2370 blood cultures, 68 cases of Escherichia coli and Klebsiella pneumoniae were detected in 68 cases and 26 cases were positive respectively. The positive rates of two strains were 3.97 %. ESBLs producing strains were 30 cases and 15 cases respectively. The total detection rate of ESBLs producing strains was 48.78% (45/94). The sensitivity of antibiotic-producing strains to commonly used antibiotics was significantly different from that of non-producing bacteria. The producing bacteria and non-producing bacteria were highly sensitive to piperacillin / tazobactam and amikacin, Drug resistance presents a trend of individuality. Conclusion The detection rate of ESBLs-producing pathogens in children with malignant hematologic malignancies after chemotherapy is high. ESBLs-producing ESBLs-producing bacteria have high resistance to conventional antibiotics, antimicrobial therapy with reference to pathogen culture and drug sensitivity test, which can greatly avoid the failure of treatment.