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目的了解医院血液疾病住院患者感染病原菌构成谱及耐药性,以指导临床合理应用抗菌药物。方法通过细菌分离培养鉴定技术和药敏试验方法,对该医院血液科2010年1月-2012年6月血液病住院患者临床送检标本进行了病原菌调查。结果调查期间从各类标本中共检出不同病原菌304株,居前3位的是革兰阴性菌占56.9%,真菌占28.3%,革兰阳性菌占14.8%。病原菌主要来自血液标本。主要病原菌为大肠杆菌,其对头孢类、庆大霉素、环丙沙星等抗菌药物耐药率较高。相关主要感染疾病中急性白血病感染占36.4%,恶性淋巴瘤占29.9%,多发性骨髓瘤占19.8%。结论血液病住院患者医院感染病原菌以革兰阴性杆菌为主,其中大肠杆菌对常用抗菌药物耐药率较高,急性白血病为化疗高发感染疾病。
Objective To understand the compositional spectrum and drug resistance of pathogens in hospitalized patients with blood diseases in order to guide clinical rational use of antimicrobial agents. Methods Bacterial isolates and culture identification technology and drug susceptibility testing methods were used to investigate the pathogenic bacteria in clinical samples of inpatients with hematological diseases from January 2010 to June 2012 in this hospital. Results A total of 304 pathogenic bacteria were detected from all kinds of specimens during the investigation. Among the top three, Gram-negative bacteria accounted for 56.9%, fungi accounted for 28.3% and Gram-positive bacteria accounted for 14.8%. Pathogenic bacteria mainly from blood specimens. The main pathogen is Escherichia coli, its cephalosporins, gentamicin, ciprofloxacin and other antimicrobial resistance rates. The major infectious diseases accounted for 36.4% of acute leukemia infections, malignant lymphoma 29.9%, multiple myeloma 19.8%. Conclusion The main pathogens of nosocomial infection in patients with hematological diseases are Gram-negative bacilli. Escherichia coli has a high resistance rate to commonly used antimicrobial agents and acute leukemia is a high-risk infection of chemotherapy.