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目的:分析血液恶性肿瘤患者化疗后肺部感染的病原学分布及耐药情况。方法:回顾性分析135例血液恶性肿瘤患者化疗后并肺部感染的临床资料。结果:135例患者共行痰培养378次,共分离出菌株195株,阳性率51.6%;2种菌混合感染18例次;检出革兰阴性菌129株(66.2%),其中铜绿假单胞菌33株(16.9%),嗜麦芽假单胞菌15株(7.7%),肺炎克雷伯杆菌27株(13.8%),鲍曼不动杆菌18株(9.2%),大肠杆菌24株(12.3%),洛菲不动杆菌6株(3.1%),弗劳氏枸橼酸杆菌3株(1.5%),结核杆菌3株(1.5%);革兰阳性菌36株(18.5%),其中金黄色葡萄球菌24株(12.3%),表皮葡萄球菌3株(1.5%),粪肠球菌9株(4.6%);真菌30株(15.4%)。药物敏感试验显示革兰阴性菌对广谱抗生素耐药。结论:对血液恶性肿瘤患者化疗后肺部感染者,应加强支持治疗,改善机体免疫力,缓解粒细胞缺乏,并积极开展痰细菌培养和药物敏感试验,合理使用抗生素,减少耐药菌株的产生,可联合抗真菌治疗。
Objective: To analyze the etiological distribution and drug resistance of lung infection after chemotherapy in patients with hematological malignancies. Methods: The clinical data of 135 patients with hematological malignancies after chemotherapy and pulmonary infection were retrospectively analyzed. Results: 135 patients were sputum culture 378 times, a total of 195 strains isolated, the positive rate was 51.6%; two kinds of bacteria mixed infection in 18 cases; 129 gram-negative bacteria were detected (66.2%), 33 strains of Escherichia coli (16.9%), 15 strains of Pseudomonas maltophilia (7.7%), 27 strains of Klebsiella pneumoniae (13.8%), 18 strains of Acinetobacter baumannii (9.2%), 24 strains of Escherichia coli (12.3%), 6 strains of Acremonium (01%), 3 strains of Fungus citronella (1.5%), 3 strains of Mycobacterium tuberculosis (1.5%), 36 strains of Gram- Including 24 strains of Staphylococcus aureus (12.3%), 3 strains of Staphylococcus epidermidis (1.5%), 9 strains of Enterococcus faecalis (4.6%) and 30 strains (15.4%) of fungi. Drug-sensitive tests show that Gram-negative bacteria are resistant to a broad-spectrum antibiotic. Conclusion: Patients with hematological malignancies after chemotherapy for lung infection should strengthen supportive treatment, improve immunity, ease agranulocytosis, and actively carry out sputum bacterial culture and drug susceptibility testing, rational use of antibiotics and reduce the generation of drug-resistant strains , Can be combined anti-fungal treatment.