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目的分析肿瘤患者下呼吸道感染的病原菌分布及耐药情况,为肿瘤合并感染的合理用药提供依据。方法对2007年1～12月间肿瘤病房送检的痰细菌培养及药敏结果进行回顾性分析。结果466份痰样品共检出病原菌287株,以白色念珠菌、肺炎克雷伯菌、大肠埃希菌为主;甲氧西林耐药株分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的75.0%、100.0%,未发现万古霉素耐药株;大肠埃希菌和肺炎克雷伯菌ESBLs的检出率分别为93.3%和65.4%,产ESBLs菌株对抗菌药物的敏感性显著降低。结论肿瘤患者下呼吸道感染以真菌和革兰阴性杆菌为主,且对常用抗菌药物耐药率高,并有多重耐药,应加强细菌耐药性监测工作,及时指导临床医师合理用药。
Objective To analyze the distribution and drug resistance of pathogenic bacteria in lower respiratory tract infection in patients with cancer and provide the basis for rational drug use in patients with tumor complicated infection. Methods The sputum bacterial culture and drug susceptibility results of the sputum ward sent from January to December 2007 were retrospectively analyzed. Results A total of 287 pathogenic bacteria were detected in 466 sputum samples, mainly Candida albicans, Klebsiella pneumoniae and Escherichia coli. Methicillin-resistant strains accounted for 75.0% of Staphylococcus aureus and coagulase-negative Staphylococcus aureus respectively %, 100.0%. No vancomycin resistant strains were found. The detection rates of Escherichia coli and Klebsiella pneumoniae ESBLs were 93.3% and 65.4%, respectively. The sensitivity of ESBLs producing strains to antimicrobial agents was significantly reduced. Conclusion The lower respiratory tract infection in patients with fungal and Gram-negative bacilli, and the resistance rate of commonly used antimicrobial drugs and multiple drug resistance, bacterial resistance should be strengthened monitoring work, timely guidance clinicians rational drug use.