血液肿瘤患儿化疗后感染产ESBLs细菌耐药性检测.docVIP

血液肿瘤患儿化疗后感染产ESBLs细菌耐药性检测 　　【摘要】 目的 检测血液肿瘤患儿化疗后血液培养产超广谱β-内酰胺酶（ESBLs）病原菌， 并进行耐药性分析。方法 对216例血液肿瘤患儿化疗后进行血培养、菌株鉴定及药敏试验， 结果按美国临床实验室标准化委员会（NCCLS）标准判读。结果 大肠埃希菌及肺炎克雷伯杆菌产ESBLs菌株检出情况 2370例次血培养中， 分别检出大肠埃希菌及肺炎克雷伯杆菌68例和26例， 两菌检出阳性率3.97%； 其中产ESBLs菌株分别为30例、15例， 产ESBLs病原菌总检出率为48.78%（45/94）。产酶菌株对常用抗生素的敏感性与未产酶菌有明显区别， 产酶菌及非产酶菌对哌拉西林/他唑巴坦及阿米卡星呈高敏感性， 对头孢类抗生素的耐药性则呈现个性化趋势。结论 恶性血液肿瘤化疗后感染患儿产ESBLs病原菌检出率较高；产ESBLs细菌对常规抗生素耐药性高， 参照病原菌培养及药物敏感性试验进行抗菌治疗， 能够极大地避免治疗失败。 　　【关键词】 血液肿瘤；超广谱β-内酰胺酶；耐药性；儿童 　　DOI：10.14163/j.cnki.11-5547/r.2015.30.001 　　Drug resistance detection of extended spectyum β-lactamase infection after chemotherapy in hematological neoplasms children YANG Ju-hong. Department of Inspection， Luoyang City the First People’s Hospital， Luoyang 471002， China 　　【Abstract】 Objective To detect pathogenic bacteria of extended spectyum β-lactamase （ESBLs） infection by blood culture after chemotherapy in hematological neoplasms children for drug resistance analysis. Methods Blood culture， strain identification， and drug sensitive test were taken in 216 in hematological neoplasms children after chemotherapy. Their results were identified by national committee for clinical laboratory standards （NCCLS） guidelines. Results Among 2370 blood culture samples of ESBLs-producing escherichia coli and klebsiella pneumonia， there were respectively 68 cases with detected escherichia coli and 26 cases with klebsiella pneumonia， and their positive rate was 3.97%. There were respectively 30 and 15 cases with ESBLs-producing strain， and the total detection rate of ESBLs-producing pathogenic bacteria was 48.78% （45/94）. There was an obvious difference of sensibility between enzyme-producing strain and non enzyme-producing strain. Enzyme-producing strain and non enzyme-producing strain showed high sensibility to piperacillin/tazobactam， and amikacin， while they showed different drug resistance to cephalosporin antibiotics. Conclusion ESBLs-producing pathogenic bacteria has high detection rate in hematological