| 摘要: |
| 目的:旨在为血液恶性肿瘤患儿的抗菌药物合理应用提供参考。方法:回顾性分析2022-2024 年我院血液科收治的血
液病/ 恶性肿瘤患儿的感染状况及抗菌药物使用情况。结果:在271 例研究对象中,菌株来源中支气管肺泡灌洗液检出率最高
(32. 72%)。革兰阴性菌检出率前3 位的分别是大肠埃希菌(28. 31%)、肺炎克雷伯菌(15. 99%)及铜绿假单胞菌(12. 50%),革
兰阳性菌中检出率前3 位的分别是金黄色葡萄球菌(12. 68%)、表皮葡萄球菌(8. 09%)、肺炎链球菌(4. 78%)。革兰阳性菌对
青霉素、红霉素等耐药率很高,革兰阴性菌对复方磺胺甲唑、环丙沙星、头孢吡肟等耐药率高。最常用的抗菌药物为β-内酰
胺类/ β-内酰胺酶抑制剂(32. 23%)。有187 例患儿(69. 00%)感染治疗疗程为7~14 天,临床转归情况好转228 例(84. 13%)。
有153 例(56. 46%)患儿在经验性抗感染治疗后进行了方案调整。2022 年3 月和6 月我院血液科抗菌药物使用率超标,2023 和
2024 年均达标。结论:本研究分析了目前我院血液肿瘤患儿感染病原菌与耐药及抗菌药物使用现状,应继续收集多家儿童医
院血液科抗感染用药相关信息,加大监测力度,促进儿童抗菌药物的合理使用。 |
| 关键词: 血液肿瘤 儿童 感染 抗菌药物 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2025.11.010 |
|
| 基金项目:基金项目:首都儿科研究所所院发展专项,编号FZYJ-2025-10。 |
|
| Analysis of Pathogenic Bacteria, Drug Resistance and Use of Antibiotics in Children with HematologicalTumors in a Children’s Hospital |
| Cui Ying, Liu Biqing, Zhong Xuli, Zhang Jianmin |
| (Capital Institute of Pediatrics, Capital Medical University, Beijing
100020, China) |
| Abstract: |
| Objective: To provide guidance for the rational use of antibiotics in children with hematological malignancies. Methods:
The basic infection status and antibiotic use of children with hematological malignancies admitted into the Hematology Department of our
hospital from 2022 to 2024 were retrospectively analyzed. Results: Of the 271 study subjects, the detection rate of bronchoalveolar
lavage fluid was the highest (32. 72%) among the strains. The top three Gram negative bacteria detection rates were respectively
Escherichia coli (28. 31%), Klebsiella pneumoniae (15. 99%), and Pseudomonas aeruginosa (12. 50%). The top three Gram positive
bacteria detection rates were respectively Staphylococcus aureus (12. 68%), Staphylococcus epidermidis (8. 09%), and Streptococcus
pneumoniae (4. 78%). Gram positive bacteria had a high resistance rate to penicillin and erythromycin, while Gram negative bacteria
had a high resistance rate to compound sulfamethoxazole, ciprofloxacin, and cefepime. The most commonly used antibiotics were
β-lactam/ β-lactam enzyme inhibitors (32. 23%). Among the 187 children (69. 00%), the treatment course of infection was from 7 to
14 d, and 228 cases (84. 13%) showed improvement in clinical outcomes. A total of 153 cases (56. 46%) underwent protocol
adjustments after empirical antibacterial treatment. In Mar. and Jun. 2022, the use rate of antibiotics in Hematology Department of our
hospital exceeded the standard, and in 2023 and 2024, both of them met the standard. Conclusion: This study analyzes the current
status of pathogenic bacteria, drug resistance and use of antibiotics in children with hematological tumors in our hospital. It is necessary
to continue collecting relevant information on anti-infection measures in the Hematology Department of children’s hospitals, increase
monitoring efforts, and promote the rational use of antibiotics in children. |
| Key words: hematological tumors children infection antibiotics |
