老年晚期肺癌化疗前后肺部感染细菌培养及药敏试验变化研究  

Research on change of spectrum distribution and drug susceptibility of bacterial culture for pulmonary infections in elderly patients with advanced cancer before and after chemotherapy

作　　者：竺顺斌[1] 杜开齐[1] 

机构地区：[1]武警浙江省总队嘉兴医院肿瘤科,浙江嘉兴314000

出　　处：《中华医院感染学杂志》2013年第8期1946-1947,共2页Chinese Journal of Nosocomiology

摘　　要：目的研究老年晚期肺癌患者化疗前、后肺部感染菌谱分布及耐药性变化,为临床预防治疗肺部感染提供参考。方法收集76例晚期肺癌患者化疗前、后的痰标本进行细菌培养及药敏试验,比较化疗前后菌谱分布及耐药性变化。结果化疗前检出病原菌62株,化疗后检出72株,化疗前、后细菌所占比例差异无统计学意义;化疗前、后检出白色假丝酵母菌分别占27.42%、44.44%,化疗后白色假丝酵母菌所占比例高于化疗前,差异有统计学意义(P<0.05);病原菌耐药率化疗前对氨曲南、氨苄西林、头孢克洛、亚胺培南耐药率分别为6.45%、19.35%、6.45%、8.06%,化疗后分别为33.33%、61.11%、37.50%、33.33%,化疗后氨曲南、氨苄西林、头孢克洛、亚胺培南等抗菌药物耐药性较化疗前高,差异有统计学意义(P<0.05)。结论老年晚期肺癌患者化疗后肺部感染细菌分离率增高,化疗对于主要抗菌药物敏感性影响不大,但对部分抗菌药物耐药性增加。OBJECTIVE To study the change of spectrum distribution and drug resistance of the pathogens causing pulmonary infections in the elderly patients with late lung cancer before and after the chemotherapy so as to provide basis for clinical prevention and treatment of the pulmonary infections.METHODS The sputum samples were collected from 76 patients with advanced lung cancer so as to analyze the spectrum distribution and drug resistance,the changes of the bacterial spectrum and the drug resistance were compared between before and after the chemotherapy.RESULTS A total of 62 strains of pathogens were isolated before the chemotherapy,and 72 strains were detected after the chemotherapy;the proportion of the Candida albicans was 27.42% before the chemotherapy,44.44% after the chemotherapy,the difference was statistically significant（P0.05）;the drug resistance rates of the pathogens to aztreonam,ampicillin,cefaclor,and imipenem were 6.45%,19.35%,6.45%,and 8.06% respectively before the chemotherapy and were 33.33%,61.11%,37.50%,and 33.33% respectively after the chemotherapy,the difference in the drug resistance rate to aztreonam,ampicillin,cefaclor,or imipenem between before and after the chemotherapy was statistically significant（P0.05）.CONCLUSION The isolation rate of the bacteria causing the pulmonary infections in the elderly patients with advanced lung cancer is increasing,the chemotherapy has little impact on the drug susceptibility to the main antibiotics,but it can increase the drug resistance to some antibiotics.

关 键 词：晚期肺癌 化疗 肺部感染 耐药性 变化 

分 类 号：R378[医药卫生—病原生物学]