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肿瘤科室感染率和耐药率不断上升。

Increasing rates of infection and resistance in an oncology department.

作者信息

Fan Li, Wang Zhe, Wang Qiang, Xiong Zhijian, Xu Ying, Li Dandan, Zhou Shiwen

机构信息

Clinical Pharmacology Base, Xinqiao Hospital, The Third Military Medical University, Chongqing, China.

Department of Oncology, Southwest Hospital, The Third Military Medical University, Chongqing, China.

出版信息

J Cancer Res Ther. 2018 Jan;14(1):68-71. doi: 10.4103/jcrt.JCRT_737_17.

Abstract

OBJECTIVE

Acinetobacter baumannii is an opportunistic pathogen found in immunocompromised patients, especially cancer patients. This study was to investigate the clinical characteristics of cancer patients and the antimicrobial resistance of A.baumannii isolates.

MATERIALS AND METHODS

Clinical isolates were collected from the oncology department of a general teaching hospital, and the clinical and demographic information of patients was obtained from the hospital's information system. Antimicrobial susceptibility was examined using the agar dilution method. Carbapenemase-encoding genes were amplified by polymerase chain reaction, and sequence types were determined by multilocus sequence typing.

RESULTS

The isolation rate of A.baumannii increased annually in the oncology department. Multivariate analysis showed that only prior antibiotic use was an independent risk factor for A.baumannii infection. The use of antibiotics in A.baumannii-infected patients was significantly more frequent than in non-A.baumannii-infected patients. A.baumannii isolates were highly resistant to most tested antibiotics. The IMP-4 and VIM-2 genes were present in 6 and 2 isolates, respectively. Sixty isolates had 12 genotypes, and ST208 was the most common genotype.

CONCLUSION

Our results suggest that the use of antibiotics and hospital environmental pollution may be the main causes of A. baumannii infection.

摘要

目的

鲍曼不动杆菌是一种在免疫功能低下患者尤其是癌症患者中发现的机会致病菌。本研究旨在调查癌症患者的临床特征以及鲍曼不动杆菌分离株的抗菌耐药性。

材料与方法

从一家普通教学医院的肿瘤科收集临床分离株,并从医院信息系统获取患者的临床和人口统计学信息。采用琼脂稀释法检测抗菌药物敏感性。通过聚合酶链反应扩增碳青霉烯酶编码基因,并通过多位点序列分型确定序列类型。

结果

肿瘤科鲍曼不动杆菌的分离率逐年上升。多变量分析表明,仅先前使用抗生素是鲍曼不动杆菌感染的独立危险因素。鲍曼不动杆菌感染患者使用抗生素的频率明显高于未感染鲍曼不动杆菌的患者。鲍曼不动杆菌分离株对大多数测试抗生素具有高度耐药性。IMP-4和VIM-2基因分别存在于6株和2株分离株中。60株分离株有12种基因型,ST208是最常见的基因型。

结论

我们的结果表明,抗生素的使用和医院环境污染可能是鲍曼不动杆菌感染的主要原因。

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