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目的了解住院食管癌患者医院感染病原菌种类及其耐药性,为临床科学选用抗菌药物提供依据。方法采用血培养方法和细菌鉴定技术,对河南部分医院住院食管癌患者送检临床标本进行检测与分析。结果从所调查的医院住院食管癌患者送检的血液标本中共检出病原菌83株,包括革兰阳性菌39株、革兰阴性菌32株和真菌12株,构成比依次为46.99%、38.55%和14.46%。检出优势菌种有凝固酶阴性葡萄球菌、金黄色葡萄球菌、大肠埃希菌和肺炎克雷伯菌,分居前4位。食管癌患者感染病原菌对临床常用抗菌药物普遍耐药,但未检出耐万古霉素和利奈唑胺革兰阳性菌株,革兰阴性菌株对亚胺培南和厄他培南高度敏感。结论食管癌患者感染病原菌以革兰阳性菌居首位,耐药严重,应加强耐药菌监测临床抗菌药物管理。
Objective To understand the types and drug resistance of nosocomial pathogens in hospitalized patients with esophageal cancer and provide the basis for selection of antimicrobial agents in clinical science. Methods The methods of blood culture and bacterial identification were used to detect and analyze clinical samples of inpatients with esophageal cancer in some hospitals in Henan Province. Results A total of 83 pathogenic bacteria were detected in blood samples from hospitalized patients with esophageal cancer, including 39 Gram-positive bacteria, 32 Gram-negative bacteria and 12 fungi, with the proportions of 46.99%, 38.55% And 14.46%. The dominant strains were detected coagulase-negative Staphylococcus aureus, Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae, the top four. Pathogens in patients with esophageal cancer were generally resistant to commonly used antibiotics, but vancomycin-resistant and linezolid-resistant Gram-positive strains were not detectable. Gram-negative strains were highly sensitive to imipenem and ertapenem. Conclusion Esophageal cancer patients with Gram-positive bacteria in the first place, the drug resistance is serious, we should strengthen the drug-resistant bacteria monitoring clinical antibacterials management.