关键词: 恶性血液病, 继发感染, 病原学分布, 耐药性, 粒细胞缺乏

Abstract:

Objective To investigate the distribution and drug resistance of pathogenic bacteria in hematological malignancy patients with secondary infection,and to provide a reference for clinical treatment,prevention and control of nosocomial infection. Methods Whonet 5.6 software was used to analyze the distribution,specimen source and drug resistance of pathogenic bacteria in hematological malignancy patients with secondary infection from April 2014 to March 2018. Results A total of 268 isolates of pathogenic bacteria were collected,of which 221 isolates （82.5%） were isolated from respiratory tract specimens,followed by 19 isolates （7.1%） from blood specimens. Gram-negative bacteria accounted for 41%,of which 7.8% were Stenotrophomonas maltophilia,6.7% were Escherichia coli,and 6.0% were Klebsiella pneumoniae,fungi accounted for 40%,and Gram-positive bacteria accounted for 19%. Gram-negative bacteria were highly resistant to ciprofloxacin,levofloxacin,ceftriaxone and aztreonam,and were sensitive to carbapenems and enzyme inhibitors. Staphylococcus and Enterococcus had high resistance to quinolones and macrolides,and were sensitive to glycopeptides and oxazolidinones. The isolation rate of Gram-negative bacteria was higher in patients with grain deficiency and fever,and the resistance rates of Klebsiella pneumoniae and Acinetobacter baumannii isolated from patients with grain deficiency and fever were higher than those without grain deficiency and fever. Conclusions The distribution and drug resistance of pathogenic bacteria in hematological malignancy patients with secondary infection have their own characteristics. Clinical laboratories should monitor pathogenic bacteria and drug resistance isolated from patients with hematological diseases,in order to provide a reference for using antibiotics rationally.

Key words: Hematological disease, Secondary infection, Distribution of pathogenic bacteria, Drug resistance, Grain deficiency