407例老年肺癌下呼吸道感染患者病原菌分布及耐药分析  

The distribution and drug resistance of pathogens in 407 senile lung cancer patients with lower respiratory tract infection

作　　者：李春香[1] 李显彬[1] 陈春荣 李林[1] 刘昊[1] 李建民[1] 徐亚茹[1] 

机构地区：[1]齐齐哈尔医学院第一附属医院检验科,黑龙江齐齐哈尔161041 [2]齐齐哈尔医学院第一附属医院肿瘤内科,黑龙江齐齐哈尔161041

出　　处：《中国微生态学杂志》2012年第11期1032-1034,共3页Chinese Journal of Microecology

摘　　要：目的分析老年肺癌下呼吸道感染患者痰培养物的病原菌分布及耐药状况。方法回顾性分析407例老年肺癌下呼吸道感染患者痰标本细菌培养、鉴定及药敏结果。结果共分离出病原菌238株,革兰阴性菌163株,占68.49%;革兰阳性菌33株,占13.87%;真菌42株,占17.65%。主要病原菌为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌、表皮葡萄球菌和金黄色葡萄球菌。其中,肺炎克雷伯菌和大肠埃希菌ESBLs阳性菌株的比例分别为36.73%、28.85%。结论老年肺癌患者因长期使用抗生素,呼吸道菌群失调,不同病原菌对抗菌药耐药率均较高,以革兰阴性菌感染为主,肺炎克雷伯菌和大肠埃希菌产ESBLs的菌株有较高比例,二重感染比例较高;革兰阳性菌均对万古霉素敏感,未发现耐药菌株。因此临床医生根据药敏结果合理选用抗生素,对于改善患者肺部微生态失衡,延长生存时间具有重要指导意义。Objective To analyze the pathogen distribution of lower respiratory tract intection and drug resistance of bacteria in senile lung cancer patients. Methods Specimens isolated from 407 cases and their culture were studied for the susceptibility to antimicrobial agents by retrospective research. Results A total of 238 strains were obtained from lower respiratory tracts of senile lung cancer patients, including 163 strains （68.78%） of Gram negative bacteria, 33 strains （ 13.87% ） of Gram positive bacteria, and 42 strains （ 17. 65% ） of Fungi. The predominant pathogens were Klebsiella pneumoniae （36.73%） and Escherichia coli （28.85%） respectively. Conclusion Microecological disturbance occurred in senile lung cancer patients due to long-term use of antibiotics. Gram negative bacilli were the major pathogens and their drug resistance were increased. ESBLs strains isolated from Klebsiella pneumoniae and Escherichia coli were increased. All Gram positive bac- teria were sensitive to Vancomyein. Drug resistance tests should be carried out so as to use antibiotics rationally and contol nos- oeomial infection.

关 键 词：菌群失调 下呼吸道感染 耐药性 肺癌 

分 类 号：R378[医药卫生—病原生物学]