Kolár M, Kurasová Y, Látal T, Hejnar P, Fáber E, Raida L
Ustav lékarské mikrobiologie LF UP, Olomouc.
Cas Lek Cesk. 1998 Feb 9;137(3):84-8.
Although Gram negative as well as Gram positive bacteria participate in febrile episodes of neutropenic patients, in particular recently the ratio of Gram positive bacteria is increasing. The objective of the present work was to investigate the incidence and antibiotic resistance of pathogenic bacterial agents in neutropenic patients.
The presence of bacteria was investigated in 446 neutropenic patients hospitalized at the Haematological Clinic in 1995. Haemocultures (apparatus Bact/Alert 120, cultivation media Organon-Teknika) and urine were examined. The sensitivity for antibiotics was tested by the standard dilution micromethod. In blood most frequently Staphylococcus epidermidis was isolated (45.4%), coagulase-negative strains of Staphylococcus haemolyticus, Staphylococcus hominis and Staphylococcus saprophyticus (14.4%), Acinetobacter calcoaceticus-baumannii (complex 6.3%) and Pseudomonas aeruginosa (6.3%). In urine the following were detected: Staphylococcus epidermidis (36.5%), Enterococcus sp. (14.5%), Escherichia coli (13.1%), Enterococcus faecalis (11.6%) and Enterococcus solitarius (6.5%). In all strains resistance to antibiotics and chemotherapeutic drugs was assessed.
Investigation of the frequency of different bacterial species, along with monitoring of the resistance is an essential prerequisite of initial antibiotic therapy of febrile episodes in neutropenic patients.
尽管革兰氏阴性菌和革兰氏阳性菌都可导致中性粒细胞减少患者出现发热症状，尤其是近年来革兰氏阳性菌的比例在增加。本研究的目的是调查中性粒细胞减少患者中病原菌的发生率及抗生素耐药情况。
1995年对血液科住院的446例中性粒细胞减少患者进行细菌检测。采用血培养仪（Bact/Alert 120）及欧加农-泰尼克公司的培养基进行血培养，并检查尿液。通过标准稀释微量法检测抗生素敏感性。血液中最常分离出表皮葡萄球菌（45.4%）、溶血葡萄球菌、人葡萄球菌和腐生葡萄球菌等凝固酶阴性葡萄球菌菌株（14.4%）、鲍曼不动杆菌（6.3%）和铜绿假单胞菌（6.3%）。尿液中检测到的有：表皮葡萄球菌（36.5%）、肠球菌属（14.5%）、大肠埃希菌（13.1%）、粪肠球菌（11.6%）和孤立肠球菌（6.5%）。对所有菌株评估了其对抗生素和化疗药物的耐药性。
调查不同细菌种类的频率并监测耐药性，是中性粒细胞减少患者发热发作初始抗生素治疗的必要前提。
