肺癌患者肺部感染的易感因素与病原菌分析  

Predisposing factors and pathogen analysis of pulmonary infection in patients with lung cancer

作　　者：叶建明[1] 方兴[1] 谭海栋[1] 

机构地区：[1]金华市人民医院胸外科,浙江金华321000

出　　处：《中华医院感染学杂志》2014年第7期1675-1677,共3页Chinese Journal of Nosocomiology

基　　金：浙江省教育厅科技基金项目(Y200909022)

摘　　要：目的通过对收治的肺癌患者的病例调查研究,对其肺部感染的易感因素、病原菌及其耐药性进行研究分析,为肺癌患者肺部感染预防和治疗提供依据。方法对医院2011年7月-2013年6月收治的肺癌且发生肺部感染的患者共62例,在住院后第2天,采集患者的痰液送至实验室进行细菌、真菌的培养,采用K-B法分离的菌株进行耐药性分析,数据均由Excel软件以及SPSS13.0软件进行处理。结果对62例患者采取的151份符合标准的痰液进行微生物培养,共检测出74株病原菌,真菌占43.24%,革兰阳性菌占9.46%,革兰阴性菌占47.30%,革兰阴性菌中肺炎克雷伯菌比例最高,真菌中的白色假丝酵母菌比例最高,肺炎克雷伯菌对氨苄西林的耐药率为100.0%,对环丙沙星无耐药性;阴沟肠杆菌对头孢他啶、头孢曲松、头孢唑林的耐药率均为100.0%;鲍氏不动杆菌对头孢唑林的耐药率为100.0%,对头孢他啶无耐药性;铜绿假单胞菌对氨苄西林、头孢唑林的耐药率均为100.0%;金黄色葡萄球菌对青霉素的耐药率为100.0%。结论对肺癌患者肺部感染进行积极的预防和控制,加强对引起肺癌患者肺部感染病原菌的监测,为医护人员对患者进行治疗、使用抗菌药物时提供参考依据,降低肺癌患者肺部感染率,提高治疗效果。OBJECTIVE To analyze predisposing factors ,pathogens and drug resistance for lung infection through case study of patients with lung cancer so as to provide reference for prevention and treatment of lung infection in patients with lung cancer .METHODS A total of 62 patients who had lung infection during hospitalization from Jul .2011 to Jun .2013 for lung cancer were selected .At two days after admission ,the sputum from the patients were delivered to the laboratory for bacteria and fungi culture .Analysis of drug resistance was conducted with bacterial strains isolated by K-B method .Data were analyzed using the software Excelland SPSS 13 .0 .RESULTS A total of 74 pathogens were detected through microbiological culture for 151 compliant sputum from 62 patients , including fungi （43 .24% ） ,gram-positive bacteria （9 .46% ） ,and gram-negative bacteria （47 .30% ） . K lebsiella pneumoniae had the highest proportion among gram-negative bacteria ,Candida albicans was the most prevalent fungus .K .pneumonia had 100% resistance to ampicillin and had no resistance to ciprofloxacin .Enterobacter clo-acae had 100% resistance to cefotazidime ,ceftriaxone ,and cephazolin .Acinetobacter baumannii had 100% resist-ance to cephazolin and had no resistance to ceftazidime .Pseudomonas aeruginosa had 100% resistance to ampicillin and cephazolin .Staphylococcus aureus had 100% resistance to penicillin .CONCLUSION Patients with lung cancer should be treated with active prevention and control for lung infection .Monitoring for pathogens causing lung infection in patients with lung cancer should be strengthened so as to provide reference for medical staff during treatment and antimicrobial medication for patients ,decrease lung infection rate and improve therapeutic efficacy .

关 键 词：肺癌 肺部感染 病原菌 耐药分析 

分 类 号：R563[医药卫生—呼吸系统]