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化疗后儿童急性淋巴细胞白血病血流感染病原菌分布及耐药谱分析。

Distribution and drug resistance profiles of pathogens causing bloodstream infection after chemotherapy in children with acute lymphoblastic leukemia.

机构信息

Department of Nosocomial Infection Control, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2022 Feb 15;24(2):176-181. doi: 10.7499/j.issn.1008-8830.2109023.

Abstract

OBJECTIVES

To study the changes in the distribution and drug resistance profiles of pathogens causing bloodstream infection after chemotherapy in children with acute lymphoblastic leukemia.

METHODS

The medical data were collected from the children with acute lymphoblastic leukemia who were admitted to the First Affiliated Hospital of Zhengzhou University between January 2015 and December 2020 and developed bloodstream infection after chemotherapy. The samples were divided into the first three years group and the next three years group according to the time of testing to investigate the differences in the distribution and drug resistance profiles of pathogens as time.

RESULTS

A total of 235 strains of pathogens were isolated, among which there were 159 Gram-negative strains (67.7%; mainly and ), 61 Gram-positive strains (26.0%; mainly ), and 15 strains of fungi (6.4%; mainly ). There were no significant differences between the first three years group and the next three years group in the detection rate of Gram-negative bacteria (68.8% vs 66.9%, >0.05) or Gram-positive bacteria (29.2% vs 23.7%, >0.05). Compared with the first three years group, the next three years group had significant increases in the detection rate of (5.8% vs 0.0%, <0.05) and fungi (9.4% vs 2.1%, <0.05). There was no significant difference in the drug resistance rate of Gram-negative or Gram-positive bacteria between the two groups (>0.05).

CONCLUSIONS

are the main pathogens of bloodstream infection after chemotherapy in children with acute lymphoblastic leukemia, while the detection rates of and fungi tend to increase as time, which needs to be taken seriously in clinical practice.

摘要

目的

研究儿童急性淋巴细胞白血病化疗后血流感染病原菌分布及耐药谱变化。

方法

收集 2015 年 1 月至 2020 年 12 月郑州大学第一附属医院收治的化疗后发生血流感染的急性淋巴细胞白血病患儿的临床资料,根据检测时间将标本分为前 3 年组和后 3 年组,分析病原菌分布及耐药谱随时间的差异。

结果

共分离出 235 株病原菌,其中革兰阴性菌 159 株(67.7%;主要为 和 ),革兰阳性菌 61 株(26.0%;主要为 ),真菌 15 株(6.4%;主要为 )。前 3 年组与后 3 年组革兰阴性菌检出率(68.8%比 66.9%,>0.05)或革兰阳性菌检出率(29.2%比 23.7%,>0.05)比较,差异均无统计学意义。与前 3 年组比较,后 3 年组 检出率(5.8%比 0.0%,<0.05)和真菌检出率(9.4%比 2.1%,<0.05)升高,差异均有统计学意义。两组革兰阴性菌或革兰阳性菌耐药率比较,差异均无统计学意义(>0.05)。

结论

是儿童急性淋巴细胞白血病化疗后血流感染的主要病原菌,而 及真菌的检出率有随时间增加而升高的趋势,临床实践中需予以重视。

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