检验医学与临床
檢驗醫學與臨床
검험의학여림상
Laboratory Medicine and Clinic
2015年
19期
2820-2822
,共3页
肖美芳%王昌富%周义正%邱小燕
肖美芳%王昌富%週義正%邱小燕
초미방%왕창부%주의정%구소연
恶性肿瘤%鲍曼不动杆菌%耐药性
噁性腫瘤%鮑曼不動桿菌%耐藥性
악성종류%포만불동간균%내약성
malignant tumor%Acinetobacter baumannii%drug resistance
目的:探讨恶性肿瘤患者鲍曼不动杆菌感染的现患率及细菌耐药性,为临床预防和诊治提供参考。方法选取恶性肿瘤患者691例,取痰液、咽拭子、穿刺液及尿液作为标本检测鲍曼不动杆菌,并通过纸片扩散法行耐药性分析。结果691例患者取不同部位标本1355份,分离得到52株鲍曼不动杆菌,检出率为3.84%,感染率为7.53%。其中男性和女性患者现患率分别为7.80%和7.21%,差异无统计学意义(P>0.05)。≥60岁恶性肿瘤患者现患率为9.09%,<60岁患者为4.13%,差异有统计学意义(P<0.05)。肺癌、大肠癌患者鲍曼不动杆菌现患率分别为10.06%和9.12%,明显多于其他部位肿瘤患者。痰液标本鲍曼不动杆菌检出率为5.93%,明显多于其他类型标本(P<0.05)。52株鲍曼不动杆菌对头孢唑林耐药率达到100.00%,对头孢呋辛、头孢曲松和庆大霉素的耐药率也较高,分别为88.46%、82.69%和78.85%;对多黏菌素耐药率最低,仅1.92%,此外对美罗培南和亚胺培南的耐药性较低,分别为11.54%和17.31%。结论不同年龄、不同原发肿瘤的患者其鲍曼不动杆菌感染现患率存在差异。在临床工作中应减少患者的侵入性操作,并规范使用抗菌药物,根据药敏试验结果选择敏感药物,控制耐药菌株产生。
目的:探討噁性腫瘤患者鮑曼不動桿菌感染的現患率及細菌耐藥性,為臨床預防和診治提供參攷。方法選取噁性腫瘤患者691例,取痰液、嚥拭子、穿刺液及尿液作為標本檢測鮑曼不動桿菌,併通過紙片擴散法行耐藥性分析。結果691例患者取不同部位標本1355份,分離得到52株鮑曼不動桿菌,檢齣率為3.84%,感染率為7.53%。其中男性和女性患者現患率分彆為7.80%和7.21%,差異無統計學意義(P>0.05)。≥60歲噁性腫瘤患者現患率為9.09%,<60歲患者為4.13%,差異有統計學意義(P<0.05)。肺癌、大腸癌患者鮑曼不動桿菌現患率分彆為10.06%和9.12%,明顯多于其他部位腫瘤患者。痰液標本鮑曼不動桿菌檢齣率為5.93%,明顯多于其他類型標本(P<0.05)。52株鮑曼不動桿菌對頭孢唑林耐藥率達到100.00%,對頭孢呋辛、頭孢麯鬆和慶大黴素的耐藥率也較高,分彆為88.46%、82.69%和78.85%;對多黏菌素耐藥率最低,僅1.92%,此外對美囉培南和亞胺培南的耐藥性較低,分彆為11.54%和17.31%。結論不同年齡、不同原髮腫瘤的患者其鮑曼不動桿菌感染現患率存在差異。在臨床工作中應減少患者的侵入性操作,併規範使用抗菌藥物,根據藥敏試驗結果選擇敏感藥物,控製耐藥菌株產生。
목적:탐토악성종류환자포만불동간균감염적현환솔급세균내약성,위림상예방화진치제공삼고。방법선취악성종류환자691례,취담액、인식자、천자액급뇨액작위표본검측포만불동간균,병통과지편확산법행내약성분석。결과691례환자취불동부위표본1355빈,분리득도52주포만불동간균,검출솔위3.84%,감염솔위7.53%。기중남성화녀성환자현환솔분별위7.80%화7.21%,차이무통계학의의(P>0.05)。≥60세악성종류환자현환솔위9.09%,<60세환자위4.13%,차이유통계학의의(P<0.05)。폐암、대장암환자포만불동간균현환솔분별위10.06%화9.12%,명현다우기타부위종류환자。담액표본포만불동간균검출솔위5.93%,명현다우기타류형표본(P<0.05)。52주포만불동간균대두포서림내약솔체도100.00%,대두포부신、두포곡송화경대매소적내약솔야교고,분별위88.46%、82.69%화78.85%;대다점균소내약솔최저,부1.92%,차외대미라배남화아알배남적내약성교저,분별위11.54%화17.31%。결론불동년령、불동원발종류적환자기포만불동간균감염현환솔존재차이。재림상공작중응감소환자적침입성조작,병규범사용항균약물,근거약민시험결과선택민감약물,공제내약균주산생。
Objective To study the prevalence rate of Acinetobacter baumannii infection in the patients with malignant tumor and the drug resistance to provide reference for clinical prevention and treatment .Methods 691 ca‐ses of malignant tumor were selected .Sputum ,pharynx swabs ,puncture fluid and urine were collected as specimens for detecting Acinetobacter baumannii ,and the drug resistance analysis was performed by using the disk diffusion method .Results 1 355 samples were taken from different parts in 691 patients ,52 strains of Acinetobacter bauman‐nii were isolated with the detection rate of 3 .84% and the infection rate of 7 .53% .The prevalence rates of males and females were 7 .80% and 7 .21% respectively ,the difference was not statistically significant(P > 0 .05) .The preva‐lence rate in malignant tumor patients aged ≥ 60 years old was 9 .09% ,which in the patients aged < 60 years old was 4 .13% ,the difference was statistically significant (P < 0 .05) .The prevalence rates of Acinetobacter baumannii in lung cancer and colorectal cancer were 10 .06% and 9 .12% respectively ,which were significantly higher than those in other parts of tumor .The detection rate of Acinetobacter baumannii was 5 .93% in sputum specimens ,which was sig‐nificantly higher than that in the other specimens ,the difference was statistically significant(P< 0 .05) .The resistant rate in 52 strains of Acinetobacter baumannii to cefazolin reached 100 .00% ,which to cefuroxime ,ceftriaxone and gentamicin were higher and were 88 .46% ,82 .69% and 78 .85% respectively ;the resistant rate to polymyxine was lowest ,only 1 .92% ,in addition ,the resistant rates to meropenem and imipenem were lower ,which were 11 .54% and 17 .31% respectively .Conclusion The prevalence rates of Acinetobacter baumannii exists in different ages and differ‐ent primary tumors .The the clinical work ,the invasive operations in the patients should be reduced .The antibacterial drugs should be normally used ,and the sensitive antibacterial drugs should be selected according to the drug suscepti‐bility test for controlling the generation of drug‐resistant strains .