血液科患者感染病原菌种类及耐药性分析

摘要

Objective To investigate distribution and drug resistance of pathogen isolated in department of he-matology ,NanFang Hospital ,Southern Medical University for using antibacterials reasonably .Methods Most bacte-ria isolates were identified with BD Phoenix100 .Candida isolates were identified by color display plate and drug sensi-tive test by K-B method .WHONET5 .6 was applied for analysis .Results The common pathogen isolated in depart-ment of hematology were Escherichia coli ,Klebsiella pneumoniae ,Pseudomonas aeruginosa ,Enterococcus faecium , Enterococcus faecalis .The incidences of Escherichia coli and Klebsiella pneumoniae isolates producing extended spec-trum beta-lactamase were 56 .1% and 33 .6% respectively .Drug resistance rate of methicillin-resistant Staphylococ-cus aureus ,Staphylococcus haemolyticus and Staphylococcus epidermidis were 20 .0% ,88 .0% and 91 .5% respective-ly .In gram negative bacillus ,lower resistance rate of antimicrobials were Imipenem ,Meropenem ,Amikacin ,Cefopera-zone/Sulbactam ,and Piperacillin/Tazobactam .In gram positive coccus ,sensitivity of Teicoplanin and Linezolid were 100 .0% .In Staphylococcus ,sensitivity of Vancomycin was 100 .0% .Candida drug resistance rate was less than 7 .0% to clinical commonly used antimicrobials .Conclusion Drug resistance rate of pathogen isolated in department of hematolog in the hospital were high ,it is important to enforce the rational use of antimicrobials for reducing the drug resistace rate .%目的了解南方医科大学南方医院血液科患者分离病原菌种类及耐药性，为合理使用抗菌药物提供依据。方法细菌鉴定和药敏试验采用BD Phoenix100仪器。念珠菌利用显色平板鉴定和K-B法进行药敏试验。数据分析用WHONET5．6软件。结果血液科患者分离病原菌中最常见的为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、屎肠球菌和粪肠球菌。大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶比例分别为56．1％和33．6％。金黄色葡萄球菌、溶血葡萄球菌和表皮葡萄球菌甲氧西林耐药率分别为20．0％、88．0％和91．5％。革兰阴性杆菌中耐药率较低的为亚胺培南、美罗培南、阿米卡星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦。革兰阳性球菌对替考拉宁和利奈唑胺的敏感率均为100．0％，葡萄球菌属对万古霉素的敏感率也为100．0％。念珠菌对临床常用抗菌药物的耐药率均低于7．0％。结论南方医科大学南方医院血液科患者分离病原菌耐药率较高，应加强抗菌药物的合理使用，以降低耐药率。