607例血液肿瘤科医院感染患者的病原菌分布及耐药性分析

目的 分析血液肿瘤科患者医院感染病原菌分布及其耐药现状.方法 收集2009年1月-2010年12月住院患者医院感染的临床标本分离病原菌,药敏试验采用K-B纸片扩散法.结果 5678例出院患者发生医院感染607例、692例次,感染率为10.69％、例次感染率为12.19％;感染部位呼吸道、胃肠道、泌尿道为前3位,占全部医院感染的86.13％；两年共分离401株细菌,其中革兰阴性杆菌198株,占49.38％,革兰阳性球菌57株,占14.21％,真菌146株,占36.41％;铜绿假单胞菌对6种抗菌药物耐药率＞50.00％,而鲍氏不动杆菌虽然检出株数少,但耐药率较高,除美罗培南外,对所检测的其他抗菌药物耐药率均≥50.00％,未检出耐万古霉素革兰阳性球菌.结论 医院感染以革兰阴性杆菌为主,真菌呈上升趋势,对常用抗菌药物耐药率较高,定期对细菌耐药性监测,为临床合理使用抗菌药物、控制医院感染具有重要意义.

Distribution of pathogenic bacteria causing hospital-acquired infections in 607 patients in hematology and tumors department and analysis of drug resistance

OBJECTIVE To study the distribution of pathogenic bacteria causing hospital-acquired infections in department of hematology and tumors and the current status of drug resistance.METHODS The isolated pathogenic bacteria obtained from inpatients were collected from Jan 2009 to Dec 2010,the drug susceptibility testing was performed by Kirby-Bauer disk diffusion method.RESULTS Of 5678 patients who discharged,nosocomial infections occurred in 607 patients(692 case-times) with the case-time infection rate of 12.19%;respiratory tract,gastrointestinal tract and the urinary tract were the top 3 sites with infections,accounting for 86.31% among all the nosocomial infections;a total of 401 strains of bacteria were isolated during the past 2 years,including 198 strains of gram-negative bacilli(49.38%),57 strains of gram-positive cocci(14.21%) and 146 strains of fungi(36.41%);the resistant rates of Pseudomonas aeruginosa to 6 antibiotics were higher than 50.00%,although Acinetobacter baumannii isolates were seldom isolated,the resistance rates were high,the resistance rates were higher than 50.00% to all the tested antibiotics except meropenem,no vancomycin-resistant gram-positive cocci were found.CONCLUSION The majority of pathogens causing hospital acquired infections are gram-negative bacilli,the fungi keep an upward tendency,the resistance rates to common antimicrobial agents are high;regular surveillance for bacterial resistance has great significance in clinical reasonable use of antibiotics and the control of nosocomial infections.