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目的:了解儿童急性白血病化疗期间院内感染的发生、细菌分布及耐药情况,探讨合理选用抗生素及其他防治措施。方法:回顾性分析本院化疗期间发生院内感染的136例急性白血病患儿的血、痰、粪细菌培养及药物敏感试验结果,分析病原菌的耐药性及抗生素的使用情况。结果:共分离出细菌161株,革兰阴性杆菌113株(70.2%),前2位为铜绿假单胞菌33株(20.5%),大肠埃希氏菌29株(18.0%);球菌35株(21.7%),其中金黄色葡萄球菌16株(9.9%),表皮葡萄球菌12株(7.4%);真菌13株(8.1%)。结论:急性白血病患儿化疗期间发生院内感染的病原菌以革兰阴性杆菌为主,病原菌显示多重耐药,革兰阴性杆菌对亚胺培南敏感性较好,革兰阳性菌对万古霉素、环丙沙星敏感性较好。
Objective: To understand the incidence of nosocomial infections, bacterial distribution and drug resistance in children with acute leukemia during chemotherapy, to explore the rational use of antibiotics and other prevention and treatment measures. Methods: The blood, sputum and fecal bacteria cultures of 136 children with nosocomial infections during hospital chemotherapy were analyzed retrospectively. The results of drug susceptibility test were analyzed. The drug resistance of pathogens and the use of antibiotics were analyzed. Results: A total of 161 bacterial strains were isolated, 113 (70.2%) were Gram-negative bacilli, the first two were 33 strains (20.5%) of Pseudomonas aeruginosa and 29 strains (18.0%) were Escherichia coli Among them, 16 (9.9%) were Staphylococcus aureus, 12 (7.4%) Staphylococcus epidermidis and 13 (8.1%) were fungi. CONCLUSION: Gram-negative bacilli are the main pathogenic bacteria causing nosocomial infection in children with acute leukemia during the chemotherapy. The pathogens showed multiple drug resistance. Gram-negative bacilli were more sensitive to imipenem. Gram-positive bacteria were more sensitive to vancomycin, Ciprofloxacin sensitivity is better.