肺癌患者伴肺部医院感染311例的病原菌分布及耐药特点  

Distribution and drug resistant pattern of pathogenic bacteria isolated from 311 cases of nosocomial infections in patients with lung cancer

作　　者：张美莲[1] 邢晓波[1] 江秀爱 赵自云 

机构地区：[1]山东省青岛市肿瘤医院检验科,山东青岛266042 [2]山东省青岛市中心医院

出　　处：《中国感染与化疗杂志》2013年第3期197-200,共4页Chinese Journal of Infection and Chemotherapy

摘　　要：目的分析肺癌患者肺部医院感染病原菌的分布及耐药特点,以便为临床合理用药和控制医院感染提供依据。方法对2010年1月至2011年12月311例住院肺癌患者肺部医院感染分离出的536株病原菌的分布及耐药性进行统计分析。结果病原菌以革兰阴性杆菌为主,占64.6%;真菌占25.0%;革兰阳性球菌占10.4%。革兰阴性杆菌对氨苄西林的耐药率高达85%以上;对庆大霉素、妥布霉素和甲氧苄啶-磺胺甲口恶唑的耐药率均高于30%。革兰阳性球菌中的金葡菌对青霉素、红霉素的耐药率均高达80%以上,肺炎链球菌对红霉素、四环素、甲氧苄啶-磺胺甲口恶唑的耐药率均高达85%以上。常见酵母样真菌除伊曲康唑外,对5氟胞嘧啶、伏立康唑、氟康唑、两性霉素B的耐药率均在10%以下。结论加强肺癌患者肺部医院感染的病原学检查和耐药监测,能有效地指导合理用药和控制医院感染。Objective To analyze the pathogen distribution and drug resistant pattern in lung cancer patients with hospital infection so as to provide basis for the clinical rational use of antibiotics and control of hospital infection. Methods From January 2010 to December 2011, a total of 536 strains of pathogenic bacteria were isolated from 311 cases of lung cancer patients with hospital infection. The clinical data were reviewed to understand the pathogen distribution and antibiotic resistance. Results Pathogenic gram negative bacilli accounted for 64.6%, fungi 25.0%, gram positive cocci 10.4%. More than 85 % of the gram negative bacilli were resistant to ampicillin. And more than 30% of these strains were resistant to gentamicin, tobramycin or cotrimoxazole. Of the gram-positive cocci, as high as 80% of S. aureus isolates were resistant to penicillin or erythromycin. More than 85% of the S. pneurnoniae isolates were resistant to erythromycin, tetracycline, or trimethoprim-sulfamethoxazole. Not more than 10% of the common fungal strains were resistant to 5-flucytosine, voriconazole, fluconazole, or amphotericin B, but itraconazole was an exception. Conclusions It is important for lung cancer patients to receive appropriate microbiological tests to identify hospital infection and the causative pathogens in time, which may facilitate the rational use of antimicrobial therapies and control of hospital infections.

关 键 词：肺癌 医院感染 病原菌 抗生素耐药性 

分 类 号：R446.5[医药卫生—诊断学]