摘要
目的探讨恶性肿瘤患者不发酵糖革兰阴性杆菌的临床分布及耐药性分析,为临床提供指导意义。方法收集恶性肿瘤患者3 940例。采集患者痰液、血液、尿液、咽拭子等标本,分离培养细菌,以法国生物梅里埃公司VITEK生物鉴定系统进行细菌鉴定。结果 247株不发酵糖革兰阴性杆菌中,痰液培养157株,血液培养46株,尿液培养30株,其他14株。不发酵糖革兰阴性杆菌中,铜绿假单胞菌105株,鲍曼不动杆菌50株,嗜麦芽窄食单胞菌41株,鲁氏不动杆菌16株,产吲哚金黄杆菌14株,荧光假单胞菌12株,溶血不动杆菌6株,其他3株。主要不发酵糖革兰阴性杆菌铜绿假单胞菌对亚胺培南和头孢他啶耐药率较高,分别为91.43%和80.95%;鲍曼不动杆菌对阿米卡星和头孢曲松耐药率较高,分别为86.00%和80.00%。耐亚胺培南铜绿假单胞菌耐药基因检测KPC-2阳性率(86.46%)最高,其次为TEM阳性率(62.50%)。结论恶性肿瘤患者不发酵糖革兰阴性杆菌培养标本中,以痰液培养为主,其次为血液培养,培养细菌中以铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌为主。
Objective To investigate the clinical distribution and drug resistance of non-fermentative Gram negative bacilli in patients with malignant tumors,so as to provide guidance for clinical practice.Methods Totally 3 940 patients with malignant tumor were collected.The sputum,blood,urine and throat swabs of the patients were collected,and the bacteria were isolated and cultured.The bacteria were identified by VITEK biological identification system of French BioMeriere company.Results Among 247 strains of non fermenting Gram negative bacilli,157 strains were cultured in sputum,46 in blood,30 in urine and 14 in others.Among the non fermenting Gram negative bacilli,105 were Pseudomonas aeruginosa,50 were Acinetobacter baumannii,41 were Stenotrophomonas maltophilia,16 were Acinetobacter rubrum,14 were Flavobacterium indole-producing,12 were Pseudomonas fluorescens,6 were Acinetobacter haemolyticus,and 3 others.The resistant rates of imipenem and ceftazidime were 91.43%and 80.95%respectively,and those of Acinetobacter baumannii to amikacin and ceftriaxone were 86.00%and 80.00%,respectively.The positive rate of KPC-2 in imipenem resistant Pseudomonas aeruginosa was 86.46%,followed by TEM positive rate of 62.50%.Conclusion In the patients with malignant tumor,phlegm is the main culture medium,followed by blood,and the main bacteria are Pseudomonas aeruginosa,Bauman Acinetobacter and Stenotrophomonas maltophilia.
作者
魏炳华
池巧珍
WEI Binghua;CHI Qiaozhen(Department of Clinical Laboratory,the Fourth People′s Hospital of Longgang District,Shenzhen,Guangdong 518123,China)
出处
《国际检验医学杂志》
CAS
2018年第21期2692-2694,共3页
International Journal of Laboratory Medicine
基金
深圳市科技局2016年度创新科技计划(SK20160711)
关键词
恶性肿瘤
不发酵糖革兰阴性杆菌
临床分布
耐药性
malignant tumor
non-fermented Gram negative bacilli
clinical distribution
drug resistance
