癌症患者痰培养常见菌谱及其耐药性分析  

Pathogen Spectrum and Drug Resistance of Spit Samples from Cancer Patients

作　　者：吴兴平[1] 张琳[1] 谭肖鹂[1] 刘晓敏[1] 何丽容[1] 

机构地区：[1]华南肿瘤学国家重点实验室

出　　处：《癌症》2007年第12期1336-1338,共3页Chinese Journal of Cancer

摘　　要：背景与目的:有些癌症患者并非死于癌症本身,而是死于手术、化疗、放疗、介入治疗后合并感染。本研究主要探讨癌症患者痰培养所得病原菌的分布及其耐药状况。方法:回顾性分析955例癌症患者医院感染痰培养感染病原菌的临床资料,采用WHONET-5软件对相关资料进行统计学处理。结果:感染菌检出率:真菌为43.4%,以白色假丝酵母菌为主;革兰氏阳性(G+)球菌为31.2%,以凝固酶阴性葡萄球菌为主;革兰氏阴性(G-)杆菌为25.4%,以铜绿假单胞菌和肺炎克雷伯菌为主。药敏试验结果提示:真菌对两性霉素B敏感,对唑类抗菌药物呈耐药性。G+球菌对万古霉素高度敏感,对苯唑西林、青霉素、红霉素等耐药率很高。G-杆菌对亚胺培南高度敏感,对一代、二代头孢菌素、氨苄西林、哌拉西林等有较高的耐药性。结论:癌症患者院内感染痰培养显示,常见菌谱为真菌、G+球菌和G-杆菌,临床用药应依据药敏试验结果合理使用抗生素。BACKGROUND ＆ OBJECTIVE： Some cancer patients were not died of cancer, but died of infection after operation, chemotherapy, radiotherapy, or interventional treatment. This study was to investigate the pathogen spectrum and drug resistance of spit samples from cancer patients. METHODS： The pathogen spectrum and drug resistance of 955 positive spit samples from cancer patients were analyzed with WHONET-5 statistical software. RESULTS： The detection rates were 43.3% for fungus （mainly included C.albicans）, 31.2% for Gram-positive coccus （mainly included coagulase-negative Staphylococcus）, and 25.5% for Gram-negative bacillus （mainly included P.aeruginosa and K.pneumonia）. Drug sensitivity test showed that fungus was sensitive to amphotericin B, but resistant against categorical azoles; Gram-positive coccus was highly sensitive to vancomycin, but highly resistant against oxacillin, penicillin and erythromycin; Gram-negative bacillus was highly sensitive to impanel, but highly resistant against the first and second generations of cephalosporin such as ampicillin and piperacillin. CONCLUSIONS： The pathogen spectrum of cancer patients with nosocomial infection mainly includes fungus, Gram-positive coccus, and Gram-negative coccus. Treating cancer patients with antibiotics should be based on drug sensitivity test.

关 键 词：癌症患者 痰培养 菌谱 耐药性 

分 类 号：R446.5[医药卫生—诊断学]