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本研究目的在于了解我院血液科医院感染的情况,并对病原菌加以分析,研究血液病房临床分离菌株的分布和变迁,探讨临床应对策略。应用回顾性调查的分析方法,对血液科病房1997-2009年住院患者中分离出的1164株病原菌进行统计分析。结果表明,13年间感染病原菌总体分布革兰阳性菌有逐渐上升趋势,但近4年增长不明显;革兰阴性菌呈逐渐下降趋势,近4年变化也趋于平稳;真菌呈逐年增加趋势。革兰阳性菌、革兰阴性菌、真菌感染分别为28.2%、59.8%、12.0%;前5位的病原菌分别为:大肠埃希氏杆菌占12.1%,铜绿色假单胞菌占9.1%,肠杆菌属占8.4%,肺炎克雷伯氏菌占7.4%,表皮葡萄球菌占6.3%,肠球菌占6.6%。革兰阳性菌和革兰阴性菌在20世纪90年代末和21世纪初分布有较明显的变化,但近几年趋于稳定;真菌的发病率呈增加趋势,这与强效广谱抗生素的广泛使用有关。结论:血液病患者是医院感染的高危人群,应作为重点监测对象;由于多种因素使其细菌培养阳性率低,血液肿瘤医师应研究并掌握病原菌变迁规律;在需要经验性用药时,应结合本院病原学特点合理应用抗生素。
The purpose of this study is to understand the situation of bloodstream hospital infection in our hospital and to analyze the pathogens to study the distribution and changes of clinically isolated strains in the blood ward and to explore the clinical coping strategies. The retrospective investigation of the method of analysis, hematology ward 1997-2009 inpatients isolated from 1164 strains of pathogenic bacteria for statistical analysis. The results showed that Gram-positive bacteria had a gradually increasing tendency over the past 13 years, but the growth rate of Gram-negative bacteria was not obvious in the past 4 years. Gram-negative bacteria showed a gradual downward trend, and the change tended to be stable in the past 4 years. The fungi showed an increasing trend year by year. Gram-positive bacteria, Gram-negative bacteria and fungal infections were 28.2%, 59.8% and 12.0% respectively. The top five pathogenic bacteria were: Escherichia coli 12.1%, Pseudomonas aeruginosa 9.1% Enterobacter accounted for 8.4%, Klebsiella pneumoniae accounted for 7.4%, Staphylococcus epidermidis accounted for 6.3%, Enterococcus accounted for 6.6%. Gram-positive bacteria and Gram-negative bacteria in the late 1990s and early 21st century distribution of the more obvious changes, but in recent years has stabilized; the incidence of fungi showed an increasing trend, which is broad-spectrum antibiotics Widely used. CONCLUSIONS: Hematopathy patients are the high risk groups of nosocomial infections and should be monitored as the key target. Due to a variety of factors that cause low positive rates of bacterial culture, hematological oncologists should study and master the pathogenic changes of pathogens. When empirical medication is needed, they should be combined Etiological characteristics of our hospital rational use of antibiotics.