[1]曹 彤,阳艳丽.急性淋巴细胞白血病患儿院内感染的病原菌分布及耐药性分析[J].新乡医学院学报,2020,37(2):173-176.[doi:10.7683/xxyxyxb.2020.02.017]
 CAO Tong,YANG Yanli.Distribution and drug resistance of pathogenic bacteria of nosocomial infection in children with acute lymphoblastic leukemia[J].Journal of Xinxiang Medical University,2020,37(2):173-176.[doi:10.7683/xxyxyxb.2020.02.017]
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急性淋巴细胞白血病患儿院内感染的病原菌分布及耐药性分析
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年2
页码:
173-176
栏目:
临床研究
出版日期:
2020-02-05

文章信息/Info

Title:
Distribution and drug resistance of pathogenic bacteria of nosocomial infection in children with acute lymphoblastic leukemia
作者:
曹 彤阳艳丽
(南京医科大学附属儿童医院检验科,江苏 南京 210000)
Author(s):
CAO TongYANG Yanli
(Department of Clinical Laboratory,Children′s Hospital of Nanjing Medical University,Nanjing 210008,Jiangsu Province,China)
关键词:
急性淋巴细胞白血病院内感染儿童耐药性
Keywords:
acute lymphoblastic leukemianosocomial infectionchildrendrug resistance
分类号:
R733.71
DOI:
10.7683/xxyxyxb.2020.02.017
文献标志码:
A
摘要:
目的 了解急性淋巴细胞白血病(ALL)患儿住院期间发生感染的病原菌分布及耐药性状况,为临床诊断和治疗提供依据。 方法 选择2016年7月至2018年6月南京医科大学附属儿童医院收治的急性淋巴细胞白血病院内感染患儿350例为观察对象,回顾性分析感染病原菌分布特点及病原菌耐药情况。 结果 送检373份标本,其中痰液217份(58.2%),血液85份(22.8%),粪便30份(8.0%),深部切口脓性分泌物15份(4.0%),尿液14份(3.8%),脑脊液10份(2.7%),腹水2份(0.5%),共检出致病菌65株,阳性率为17.4%(65/373)。检出的65株致病菌来自痰液47株(72.3%),大便8株(12.3%),深部切口脓性分泌物4株(6.15%),血液3株(4.62%),尿液3株(4.6%)。65株病原菌中,革兰阳性菌14株(21.5%),其中金黄色葡萄球菌6株(9.2%),肺炎链球菌4株(6.2%),其他阳性菌4株(6.2%);真菌2株(3.1%);革兰阴性菌49株(75.4%),其中流感嗜血杆菌11株(16.9%),肺炎克雷伯菌11株(16.9%),铜绿假单胞菌10株(15.4%),大肠埃希菌9株(13.8%),其他阴性菌8株(12.3%)。有7株病原菌表现为多重耐药,其中耐甲氧西林葡萄球菌2株,大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌、脑膜败血伊丽莎白菌、肺炎链球菌各1株。有4株肺炎克雷伯菌、3株铜绿假单胞菌、2株大肠埃希菌表现为对碳青霉烯类抗生素耐药。结论 ALL患儿院内感染最常见的感染部位为呼吸道,其次为肠道,多重耐药菌感染比例较高。
Abstract:
Objective To investigate the distribution and drug resistance of pathogenic bacteria of children with acute lymphoblastic leukemia(ALL) during hospitalization,and provide evidence for clinical diagnosis and treatment.Methods Three hundred and fifty ALL children with nosocomial infection in Children′s Hospital Affiliated to Nanjing Medical University from July 2016 to June 2018 were selected as the study objects;the distribution characteristics and drug susceptibility of pathogenic bacteria were analyzed retrospectively.Results Among the 373 samples,217 (58.2%) of sputum,85 (22.8%) of blood,30 (8.0%) of feces,15 (4.0%) of purulent secretion, 14 (3.8%) of urine,10 (2.7%) of cerebrospinal fluid and 2 (0.5%) of ascites;a total of 65 strains of pathogenic bacteria were detected,the positive rate was 17.4% (65/373).Among the 65 strains pathogens,47 strains (72.3%)were from sputum,8 strains (12.3%) were from stool,4 strains(6.2%) were from purulent secretion,3 strains (4.6%) were from blood and 3 strains(4.6%) were from urine.Of the 65 pathogenic strains,there were 14 strains (21.5%) of gram-positive bacteria,including 6 strains (9.2%) of Staphylococcus aureus,4 strains (6.2%) of Streptococcus pneumoniae,and 4 strains (6.2%) of other positive strains;there were 2 strains (3.1%) of fungi;there were 49 strains (75.4%) of gram-negative bacteria,including 11 strains(16.9%) of Haemophilus influenzae,11 strains (16.9%)of Klebsiella pneumoniae,10 strains (15.4%)of Pseudomonas aeruginosa,9 strains(13.8%) of Escherichia coli,and 8 strains(12.3%) of other negative bacteria. Seven pathogens showed multi-drug resistance,including 2 strains of Methicillin resistant staphylococci,1 strain of Escherichia coli,1 strain of Pseudomonas aeruginosa,1 strain of Acinetobacter baumannii,1 strain of Elisabeth meningeal septicemia,and 1 strain of Streptococcus pneumoniae.In addition,4 strains of Klebsiella pneumoniae,3 strains of Pseudomonas aeruginosa and 2 strains of Escherichia coli showed carbopenem resistance.Conclusions The most common nosocomial infection site of nosocomial infection of ALL children was respiratory tract infection,followed by intestinal infection.The proportion of multidrug-resistant bacteria is higher.

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更新日期/Last Update: 2020-02-05