淋巴瘤化疗后继发感染患者病原菌及耐药性分析

分析淋巴瘤化疗后继发感染患者病原菌分布及病原菌对常见抗菌药物的敏感性，从而为制定患者干预方案、提高患者生活质量提供参考依据。

以经病理确诊的淋巴瘤化疗后继发感染患者为研究对象，采集患者血液、尿液、痰液和粪便样本。采用VITEK 2 COMPACT全自动微生物鉴定及药敏分析仪鉴定病原菌种类，采用Mueller-Hinton琼脂平板和Kirby-Bauer纸片扩散法测定分离的主要病原菌菌株对常见抗菌药物的敏感性。

455例淋巴瘤病人，总计住院1 776人次，累计有356人次发生化疗后继发感染，发生率为20.1%。累计培养出病原菌106株，以大肠埃希菌和肺炎克雷伯菌为主。大肠埃希菌对头孢替坦、阿米卡星、亚胺培南、美罗培南、厄他培南敏感性均＞95%；肺炎克雷伯菌对阿米卡星、头孢替坦、亚胺培南、美罗培南、厄他培南敏感性均＞90%；金黄色葡萄球菌对呋喃妥因、利奈唑胺、替加环素、万古霉素、喹奴普汀/达福普汀敏感性均为100%；铜绿假单胞菌对多黏霉素B敏感性为100%，对哌拉西林/他唑巴坦、头孢吡肟、阿米卡星、庆大霉素、妥布霉素、亚胺培南敏感性均达87.5%。

淋巴瘤住院患者化疗后继发感染发生率较高，大肠埃希菌和肺炎克雷伯菌为主要病原菌，大肠埃希菌和肺炎克雷伯菌对阿米卡星、头孢替坦、亚胺培南、美罗培南、厄他培南敏感性较高。

Distribution and resistance of pathogenic bacteria among lymphoma patients with secondary infections following chemotherapy

ObjectiveTo observe the distribution of pathogenic bacteria among lymphoma patients with secondary infections following chemotherapy (SIFC) and test the susceptibility of pathogenic bacteria to common antimicrobial agents, so as to provide insights into the formulation of interventions and improvements of the quality of life among lymphoma patients. MethodsLymphoma patients with SIFC were enrolled, and the samples of urine, blood, sputum and stool were collected. The pathogenic bacteria were identified using the VITEK 2 COMPACT automated identification and susceptibility testing system, and the susceptibility of major pathogenic bacteria to common antimicrobial agents was tested with Mueller-Hinton agar plates and Kirby-Bauer disk diffusion method. ResultsThere were 356 person-times with SIFC among 1, 776 person-times out of a total of 455 inpatients with lymphoma, with a prevalence of 20.1%. A total of 106 pathogenic bacterial isolates were cultured, with Escherichia coli and Klebsiella pneumoniae as predominant bacterial isolates. E. coli showed a susceptibility of more than 95% to cefotetan, amikacin, imipenem, meropenem and ertapenem. K. pneumoniae presented a susceptibility of more than 90% to amikacin, cefotetan, imipenem, meropenem and ertapenem. Staphylococcus aureus was 100% susceptible to furantoin, linezolid, tigecycline, vancomycin and quinopritin/dafopritin. Pseudomonas aeruginosa was 100% susceptible to polymyxin B, and presented a susceptibility of more than 87.5% to piperacillin/tazobactam, cefepime, amikacin, gentamicin, tobramycin and imipenem. ConclusionThere is a high prevalence of secondary infections among lymphoma patients following chemotherapy, and E. coli and K. pneumoniae are predominant pathogenic bacterial isolates which are highly susceptible to ampicillin, cefotetan, imipenem, meropenem and ertapenem.