血液病并发血流感染患者血标本中病原菌的分布与耐药特点以及疾病致死的危险因素分析

李乔

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抗感染药学 ›› 2022, Vol. 19 ›› Issue (3) : 331-334. DOI: 10.13493/j.issn.1672-7878.2022.03-005
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血液病并发血流感染患者血标本中病原菌的分布与耐药特点以及疾病致死的危险因素分析

  • 李乔*
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Analysis of Distribution and Drug Resistance Characteristics of Pathogenic Bacteria in Blood Specimens of Patients with Hematological Diseases Complicated by Blood Stream Infection and Risk Factors for Mortality

  • LI Qiao*
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摘要

目的: 分析血液病患者并发血流感染(blood stream infection,BSI)的病原菌分布与耐药特点以及疾病致死的危险因素。方法: 选取 2019 年 5 月—2021 年 5 月河南科技大学第一附属医院收治的 95 例血液病合并 BSI 患者的病历资料,统计患者血标本的细菌培养和药敏试验结果,分析病原菌的分布及其耐药特点,探究疾病致死的危险因素。结果: 95 例并发 BSI 患者血标本中共分离出病原菌 98 株,其中革兰阴性菌 59 株(占 60.20%)、革兰阳性菌 36 株(占 36.74%)和真菌 3 株(占 3.06%);药敏结果显示,大肠埃希菌和肺炎克雷伯菌对美罗培南、亚胺培南的耐药率均较低(<15.00%),人葡萄球菌和金黄色葡萄球菌对利奈唑胺、替考拉宁、万古霉素的耐药率为 0.00%;回归分析结果显示,血液病并发 BSI 患者病亡与深静脉导管留置时间 ≥7 d、抗菌药物未合理使用和 SOFA 评分值≥5 分具有相关性,是引起患者死亡的独立危险因素。结论: 血液病患者并发 BSI 的病原菌主要为革兰阴性菌,临床应定期监测病原菌分布及其耐药情况,以提高抗感染治疗的疗效;同时,还要注意是否存在深静脉导管留置时间过长、抗菌药物未合理使用和 SOFA 评分值过高等危险因素,以便于临床规避相应风险,确保患者的生命安全。

Abstract

Objective: To analyze distribution and drug resistance characteristics of pathogenic bacteria in patients with hematological diseases complicated by blood stream infection (BSI), and the risk factors for mortality. Methods: The medical records of 95 patients with hematological diseases complicated by BSI who were admitted to the First Affiliated Hospital of Henan University of Science and Technology from May 2019 to May 2021 were selected, the bacterial culture and susceptibility test results of blood specimens of patients were summarized, and the distribution and drug resistance characteristics of pathogenic bacteria were analyzed, to explore the risk factors of mortality. Results: A total of 98 pathogenic bacteria were isolated from the blood samples of 95 patients complicated by BSI, including 59 Gram-negative bacteria (60.20%), 36 Gram-positive bacteria (36.74%) and 3 fungi (3.06%); the drug susceptibility results showed that the drug resistance rates of Escherichia coli and Klebsiella pneumoniae to meropenem and imipenem were lower (<15.00%), while the drug resistance rates of Staphylococcus hominis and Staphylococcus aureus to linezolid, teicoplanin and vancomycin were 0.00%. The regression analysis results showed that the death of patients with hematological diseases complicated by BSI was associated with the time of indwelling deep venous catheter≥7d, irrational use of antibacterial drugs and SOFA score≥5, which were independent risk factors for death of patients. Conclusion: The pathogenic bacteria in patients with hematological diseases complicated by BSI are mainly Gram-negative bacteria. The distribution and drug resistance of pathogenic bacteria should be regularly monitored in clinic practices to improve the efficacy of anti-infective therapy; meanwhile, attention should be paid to the risk factors, such as too long time of indwelling deep venous catheter, irrational use of antibacterial drugs and too high SOFA score so as to avoid the risks in clinical practice and ensure the life safety of patients.

关键词

血液病 / 血流感染 / 病原菌 / 耐药性 / 危险因素

Key words

hematological diseases / blood stream infection / pathogenic bacteria / drug resistance / risk factors

引用本文

导出引用
李乔. 血液病并发血流感染患者血标本中病原菌的分布与耐药特点以及疾病致死的危险因素分析. 抗感染药学. 2022, 19(3): 331-334 https://doi.org/10.13493/j.issn.1672-7878.2022.03-005
LI Qiao. Analysis of Distribution and Drug Resistance Characteristics of Pathogenic Bacteria in Blood Specimens of Patients with Hematological Diseases Complicated by Blood Stream Infection and Risk Factors for Mortality. KANGGANRAN YAOXUE. 2022, 19(3): 331-334 https://doi.org/10.13493/j.issn.1672-7878.2022.03-005

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