[血液科患者分离病原菌的分布及药敏分析]
[Distribution and Drug Sensitivity Analysis of Pathogenic Bacteria Isolated from Patients in Hematology Department].
作者信息
Qian Li, Xia Wen-Ying, Ni Fang, Zhang Xiao-Hui
机构信息
Department of Laboratory Medicine, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing 210031, Jiangsu Province, China.
Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing 210029, Jiangsu Province, China.
出版信息
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023 Apr;31(2):568-574. doi: 10.19746/j.cnki.issn.1009-2137.2023.02.037.
OBJECTIVE
To investigate the distribution and drug sensitivity of pathogenic bacteria isolated from patients in hematology department, in order to provide evidence for rational use of antibiotics in clinic.
METHODS
The distribution of pathogenic bacteria and drug sensitivity data of patients in the hematology department of The First Affiliated Hospital of Nanjing Medical University from 2015 to 2020 were retrospectively analyzed, and the pathogens isolated from different specimen types were compared.
RESULTS
A total of 2 029 strains of pathogenic bacteria were isolated from 1 501 patients in the hematology department from 2015 to 2020, and 62.2% of which were Gram-negative bacilli, mainly Gram-positive coccus accounted for 18.8%, mainly Coagulase-negative (CoNS) and . Fungi (17.4%) were mainly candida. The 2 029 strains were mainly isolated from respiratory tract (35.1%), blood (31.8%) and urine (19.2%) specimens. Gram-negative bacilli were the main pathogenic bacteria in different specimen types (>60%). and were the most common pathogens in respiratory specimens, were common in blood samples, and and were most common in urine samples. Enterobacteriaceae had the highest susceptibility to amikacin and carbapenems (>90.0%), followed by piperacillin/tazobactam. strains had high sensitivity to antibiotics except aztreonam (<50.0%). The susceptibility of to multiple antibiotics was less than 70.0%. The antimicrobial resistance rates of and in respiratory tract specimens were higher than those in blood specimens and urine specimens.
CONCLUSION
Gram-negative bacilli are the main pathogenic bacteria isolated from patients in hematology department. The distribution of pathogens is different in different types of specimens, and the sensitivity of each strain to antibiotics is different. The rational use of antibiotics should be based on different parts of infection to prevent the occurrence of drug resistance.
目的
调查血液科患者分离出的病原菌分布及药敏情况，为临床合理使用抗生素提供依据。
方法
回顾性分析南京医科大学第一附属医院血液科2015年至2020年患者病原菌分布及药敏数据，并比较不同标本类型分离出的病原菌。
结果
2015年至2020年血液科1501例患者共分离出2029株病原菌，其中革兰阴性杆菌占62.2%，主要为凝固酶阴性葡萄球菌（CoNS），占18.8%。真菌（17.4%）主要为念珠菌。2029株病原菌主要分离自呼吸道标本（35.1%）、血液标本（31.8%）和尿液标本（19.2%）。革兰阴性杆菌是不同标本类型中的主要病原菌（>60%）。肺炎克雷伯菌和鲍曼不动杆菌是呼吸道标本中最常见的病原菌，大肠埃希菌在血液标本中常见，大肠埃希菌和白色念珠菌在尿液标本中最常见。肠杆菌科对阿米卡星和碳青霉烯类药物敏感性最高（>90.0%），其次为哌拉西林/他唑巴坦。嗜麦芽窄食单胞菌对除氨曲南外的抗生素敏感性较高（<50.0%）。鲍曼不动杆菌对多种抗生素的敏感性低于70.0%。呼吸道标本中肺炎克雷伯菌和鲍曼不动杆菌的耐药率高于血液标本和尿液标本。
结论
革兰阴性杆菌是血液科患者分离出的主要病原菌。不同类型标本中病原菌分布不同，各菌株对抗生素的敏感性也不同。应根据感染部位合理使用抗生素，以预防耐药的发生。
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