【摘要】 目的探讨白血病患者并发血流革兰菌感染的临床特点及其耐药性情况。方法选取95例白血病并发血流革兰菌感染的患者为研究对象,分析患者的病原菌种类、分布,临床特征及耐药情况。结果 95例血流革兰菌感染者中52例(54.74%)为革兰阴性(G-)杆菌感染,共检测菌株185株;43例(23.24%)为革兰阳性(G+)球菌感染,共检出菌株128株。G-杆菌感染者临床症状表现为高热寒战,而G+球菌感染则表现为中低度发热G-杆菌感染者体温、CRP、PCT水平均高于G+球菌组,差异具有统计学意义(P均<0.05)。G-杆菌感染者对哌拉西林他唑巴坦(TZP)以及左氧沙星(LVX)的药敏性较高,而对头孢唑啉(KZ)、胺曲南(ATM)、头孢美唑(CMZ)、头孢他啶(CAZ)的敏感性较低。G+球菌均对替考拉宁(TEG)及万古霉素(VAM)药敏性较高,而对其他抗菌药物表现为较低的药敏性。结论 G-杆菌对TZP和LVX药敏性较高,而G+球菌对TEG和VAM药敏性较高。临床应重视白血病患者病原学调查,并应根据患者的临床体征及药敏试验选取合适的治疗方案,以降低白血病患者血流革兰菌感染发生率及病死率。更多还原

【Abstract】 Objective To investigate the clinical characteristics of leukemia patients with Gram bacterial bloodstream infection and the drug resistance. Methods Total of 95 cases of leukemia complications bloodstream infections with Gram bacterial infection were selected. The pathogens and the distribution, clinical features and the drug resistance were analyzed, respectively. Results Among the 95 cases with bloodstream infection, there were 52(54.74%) cases with Gram-negative(G-) bacterial infection, a total of 185 strain of clinical isolates. While there were 43(23.24%) cases with Gram-positive(G+) bacterial infection, a total of 128 strains of clinical isolates. The clinical symptoms was high fever chills in patients with G- bacteria infection, while were manifested in low-grade fever in patients with G+ bacteria infection. The patients with G- bacteria infection were higher susceptibility to piperacillin-tazobactam(TZP) and levofloxacin(LVX), and were less susceptibility to cefazolin(KZ), amine aztreonam(ATM), cefmetazole(CMZ), ceftazidime(CAZ). G+ cocci were were with higher sensitivity to teicoplanin(TEG) and vancomycin(VAM), while the other showed a lower antibiotic susceptibility. Conclusions G- bacillus were with high sensitivity to TZP and LVX, and the G+ cocci with high sensitivity to TEG and VAM. The clinical etiology investigation of leukemia patients should be pay attention to, and the appropriate treatment should be selected according to the patient’s clinical features and the resultd of drug sensitive test, in order to reduce the incidence of infection and fatality rate of leukemia patients with Gram bacteria infection in blood.更多还原