肿瘤患者感染三种常见革兰阴性杆菌耐药性分析

目的分析肿瘤患者临床分离的革兰阴性杆菌分布及其主要菌株的耐药性,为指导临床合理用药提供依据。方法对2014年1月~2015年12月恶性肿瘤患者感染分离的1478株革兰阴性杆菌及其主要菌株的耐药性进行回顾性分析。结果分离的1478株革兰阴性杆菌中,以大肠埃希菌(568/1478)38.43%、肺炎克雷伯菌(338/1478)22.87%、铜绿假单胞菌(216/1478)14.61%3种为主。这3种革兰阴性杆菌均呈多药耐药性;除亚胺培南对革兰阴性杆菌有较好的抗菌活性外,其它药物均显示有一定的耐药性,其中对派拉西林的耐药率在91%以上,头孢他啶、头孢噻肟、复方新诺明等药物的耐药率在70%以上。结论肿瘤患者感染革兰阴性杆菌耐药现象严重,尤其是感染产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌呈多重耐药,实验室应加强对革兰阴性杆菌耐药性的监测,以指导临床合理选用抗菌药物。

Analysis of Drug Resistance to Three Kinds of Commonly Seen Gram Negative Bacilli Infected by Cancer Patients

Objective To investigate the distribution and drug resistance of 1478 strains of gram negative bacilli clinically isolated from cancer patients and provide reference to the rational use of medicines in clinics . Methods The drug resistance of 1478 strains of gram negative bacilli clinically isolated from cancer patients from January , 2014 to December ,2015 was retrospectively analyzed . Results There were mainly three kinds of bacilli in the i‐solated 1478 strains of gram negative bacilli .They were Escherichia Coli ,Klebsiella Pneumoniae and Pseudomonas Aeruginosa ,accounting for 38.43% (568/1478) ,22.87% (338/1478) and 14.61% (216/1478) separately and they all had a multidrug resistance .Except that gram negative bacilli were more sensitive to imipenem ,the other drugs were ineffective ,of which the resistance rate of PiPRAcil was more than 91% while the resistance rate of ceftazi‐dime ,cefotaxime ,trimethoprim and sulphame‐thoxazole and the other drugs was more than 70% . Conclusion Gram negative bacilli infected by cancer patients had a serious drug resistance .In particularly escherichia coli and klebsiella pneumoniae with ESBLs had a more serious cross‐drug resistance .Clinical Laboratory should put more punch into monitoring drug resistance of gram negative bacilli and provide reference to the rational use of antibacte‐rials .