CAJ | 학술논문

目的：了解医院恶性血液病患者血流感染的病原菌谱与抗生素耐药性，为临床应用抗生素提供合理的实验依据。方法回顾性分析1005例恶性血液病患者中121例并发血流感染者的临床资料、分离的病原菌种类及其对抗生素的耐药性及特点。结果1005例恶性血液病患者中，血流感染的发生率为12.04%(121/1005)，血培养的阳性率为61.16%(74/121)。革兰阳性菌、革兰阴性菌和真菌类分别为54.1%(40/74)、41.9%(31/74)和4.1%(3/74)。居前三位的细菌分别是表皮葡萄球菌(20.3%)、大肠杆菌(16.2%)和肺炎克雷伯菌(16.2%)。药敏结果表明：葡萄球菌对万古霉素和利奈唑胺具有高敏感性，大肠杆菌和肺炎克雷伯菌对头孢哌酮/舒巴坦和亚胺培南高度敏感。结论本院恶性血液疾病血流感染患者以革兰阳性菌为主，根据敏感性检测结果的抗生素选择应用要优于经验性治疗。因此对于血流感染患者在早期阶段根据耐药性检测正确地应用抗生素药物治疗非常重要。
목적：료해의원악성혈액병환자혈류감염적병원균보여항생소내약성，위림상응용항생소제공합리적실험의거。방법회고성분석1005례악성혈액병환자중121례병발혈류감염자적림상자료、분리적병원균충류급기대항생소적내약성급특점。결과1005례악성혈액병환자중，혈류감염적발생솔위12.04%(121/1005)，혈배양적양성솔위61.16%(74/121)。혁란양성균、혁란음성균화진균류분별위54.1%(40/74)、41.9%(31/74)화4.1%(3/74)。거전삼위적세균분별시표피포도구균(20.3%)、대장간균(16.2%)화폐염극뢰백균(16.2%)。약민결과표명：포도구균대만고매소화리내서알구유고민감성，대장간균화폐염극뢰백균대두포고동/서파탄화아알배남고도민감。결론본원악성혈액질병혈류감염환자이혁란양성균위주，근거민감성검측결과적항생소선택응용요우우경험성치료。인차대우혈류감염환자재조기계단근거내약성검측정학지응용항생소약물치료비상중요。
Objective To understand pathogenic bacteria spectra and antibiotic resistance in bloodstream infection patients with malignant hematological disease, in order to provide rational experimental reference for clinical application. Methods A retrospective analysis was made on clinical data, separated pathogenic bacteria types, antibiotic resistance and characteristics in 121 patients complicated with bloodstream infection among 1005 malignant hematological disease patients. Results Among the 1005 patients, the incidence of bloodstream infection was 12.04% (121/1005), positive rate of blood culture was 61.16% (74/121), and proportion of gram positive bacteria, gram negative bacteria, and fungus were respectively 54.1% (40/74), 41.9%(31/74), and 4.1% (3/74). The first three kinds of bacteria were staphylococcus epidermidis (20.3%), escherichia coli (16.2%), and klebsiella pneumonia (16.2%). Drug sensitivity results showed that staphylococcus was highly sensitive to vancomycin and linezolid, escherichia coli and klebsiella pneumonia contained high sensitivity to cefoperazone/sulbactam and imipenem. Conclusion Gram positive bacteria is the main pathogenic bacteria for bloodstream infection patients with malignant hematological disease in our hospital, and choice of antibiotics on the basis of sensitivity detection is better than empirical therapy. Therefore, it is essential for correct antibiotics application based on early drug resistance detection for bloodstream infection patients.