中晚期肿瘤患者肺部感染的病原菌分布  

Distribution investigation of pathogens causing pulmonary infections to terminal-stage cancer patients

作　　者：刘艳萍[1] 张俊华[1] 郭本成[2] 

机构地区：[1]莱芜市人民医院药剂科,山东莱芜271100 [2]莱芜市人民医院肿瘤科,山东莱芜271100

出　　处：《中华医院感染学杂志》2014年第10期2383-2385,共3页Chinese Journal of Nosocomiology

基　　金：莱芜市卫生局医学研究基金资助项目(鉴字[2006]035)

摘　　要：目的探讨莱芜市人民医院中晚期肿瘤患者合并肺部感染的病原菌分布及抗菌药物的应用情况,以期提高临床对中晚期肿瘤患者肺部感染的诊治水平。方法选取医院治疗的中晚期肿瘤患者中合并肺部感染的患者89例为研究对象,留取患者的痰液标本行痰培养及药敏试验,使用法国生物梅里埃公司VITEK-2全自动细菌鉴定仪,参照卫生部《全国临床检验操作规程》鉴定,用K-B纸片扩散法进行药敏试验,采用SPSS13.0软件进行统计分析。结果共分离出病原菌336株,其中革兰阴性菌242株占72.02%,革兰阳性菌73株占21.73%,真菌21株占6.25%,以铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷伯菌和金黄色葡萄球菌4种病原菌最为常见,分别占23.81%、15.48%、11.94%和16.07%;铜绿假单胞菌、鲍氏不动杆菌和肺炎克雷伯菌对美罗培南的耐药性较低,分别为5.00%、26.92%和2.50%,金黄色葡萄球菌对呋喃妥因耐药率较低,为7.41%。结论中晚期肿瘤合并肺部感染患者的致病菌以革兰阴性菌为主,美罗培南和呋喃妥因可作为治疗感染的有效药物。OBJECTIVE To investigate the distribution of pathogens causing complicated pulmonary infections to terminal-stage cancer patients and the using status of antibiotics in Laiwu City People＇s Hospital, so as to improve the diagnosis and treatment level for terminal-stage cancer patients with pulmonary infection in clinical practice. METHODS A total of 89 cases of terminal-stage cancer patients complicated with pulmonary infections in the hospital were selected as study subjects; sputum of patients were obtained for sputum culture and drug sensitivity test; the French BioMerieux VITEK-2 full-automatic bacteria identification instrument was used for identification as per National Clinical Laboratory Practice issued by the Ministry of Health; Kirby-Bauer method was adopted for drug sensitivity test and SPSS 13.0 software was adopted for statistical analysis. RESULTS A total of 336 strains of pathogens were isolated, with 242 strains of gram-negative bacteria （72. 02~）, 73 strains of gram-positive bacteria （21.73%）, and 21 strains of fungi （6.25%）. Pseudomonas aeruginosa, Acinetobacterbaumannii, Kleb- siella pneumoniae and Staphylococcus aureus were the top 4 common types of pathogens accounting for 23.81%, 15.48~, 11.94~ and 16.07~ respectively. P. aeruginosa, A. baumannii, and K. pneumoniae had low drug resistance to meropenem, which were 5. 00%, 26. 92% and 2. 50% respectively. S. aureus had low drug resistance to macrodantin, which was 7. 41%. CONCLUSIONS The pathogens causing complicated pulmonary infection to terminal-stage cancer patients were dominated by gram-negative bacteria and meropenem and macrodantin can be used as effective drugs for treating the infections.

关 键 词：中晚期肿瘤 肺部感染 病原菌 分布 耐药性 

分 类 号：R378[医药卫生—病原生物学]