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2019−2023年6428例肿瘤患者病原菌分布与耐药性监测报告

Distribution of the Pathogens Isolated from 6428 Tumor Patients in 2019-2023 and the Relevant Drug Resistance Surveillance Report

  • 摘要:
    目的  报告近五年某医院从肿瘤患者样本分离的病原菌特征和多重耐药菌检出率,为感染防控提供参考。
    方法  回顾性收集四川大学华西医院2019年1月−2023年12月期间6428例肿瘤患者样本的病原学培养及菌株体外敏感性结果,总结数据趋势。
    结果 从80386份样本中分离到病原菌16393株,检出率为20.4%;剔除从同一患者分离的重复菌株,7951株(81.1%)细菌菌株中以大肠埃希菌(14.5%)、肺炎克雷伯菌(13.2%)、金黄色葡萄球菌(9.4%)、鲍曼不动杆菌复合群(9.3%)和铜绿假单胞菌(7.7%)为主;1857株(18.9%)真菌菌株中以白色念珠菌(56.5%)、热带念珠菌(9.0%)和近平滑念珠菌(8.0%)最常见。主要菌种的样本来源不同,不同肿瘤来源的菌种分布也不同(P<0.05)。耐碳青霉烯大肠埃希菌和肺炎克雷伯菌的检出率分别为2.5%(29/1152)和12.3%(129/1050);耐甲氧西林金黄色葡萄球菌的检出率为22.0%(165/749),近四年的检出率呈上升趋势(P<0.01);耐碳青霉烯鲍曼不动杆菌和铜绿假单胞菌的检出率分别为40.3%(298/739)和8.8%(54/612)。
    结论  肿瘤患者病原菌以革兰阴性菌为主,多重耐药菌的检出率较高,耐甲氧西林金黄色葡萄球菌的检出率呈上升趋势。

     

    Abstract:
    Objective To investigate the characteristics of the pathogens isolated from the specimens of tumor patients and detection rates of multidrug-resistant bacteria in a hospital in the past five years, so as to provide references for infection prevention and control.
    Methods The results of pathogenic culture and in vitro susceptibility of the strains isolated from the specimens collected between January 2019 and December 2023 from tumor patients were retrospectively collected, and the trends of the data were analyzed and summarized.
    Results A total of 16393 strains were isolated from 80386 specimens, producing a detection rate of 20.4%. After excluding the duplicate strains isolated from the same patients, Escherichia coli (14.5%), Klebsiella pneumoniae (13.2%), Staphylococcus aureus (9.4%), Acinetobacter baumannii complex (9.3%), and Pseudomonas aeruginosa (7.7%) predominated the 7951 (81.1%) bacterial strains. Among the 1857 (18.9%) fungal strains, Candida albicans (56.5%), Candida tropicalis (9.0%), and Candida parapsilosis (8.0%) were the most common ones. The specimen sources differed among the prevalent species, and the species distribution varied among specimens from different types of tumors (P<0.05). The detection rates of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae were 2.5% (29/1152) and 12.3% (129/1050), respectively. The detection rate of methicillin-resistant Staphylococcus aureus was 22.0% (165/749), maintaining an upward trend in the last four years (P<0.01). The detection rates of carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa were 40.3% (298/739) and 8.8% (54/612), respectively.
    Conclusion Gram-negative bacteria were the prevalent pathogens of tumor patients. The detection rate of multidrug-resistant bacteria was relatively high, and the detection rate of methicillin-resistant Staphylococcus aureus showed an upward trend.

     

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