非小细胞肺癌放化疗患者医院感染病原菌特点和影响因素分析  

Characteristics and influencing factors of pathogens causing nosocomial infections in patients with non-small cell lung cancer after radiotherapy and chemotherapy

作　　者：沙晓锋 赵亚萍[2] 丁颖[2] 宋增芳 丁洁 张姣[3] SHA Xiao-feng;ZHAO Ya-ping;DING Ying;SONG Zeng-fang;DING Jie;ZHANG Jiao(People's Hospital of Hongze District,Huaian,Jiangsu 223001,China)

机构地区：[1]江苏省淮安市洪泽区人民医院肿瘤科,江苏淮安223001 [2]中国人民解放军第82医院检验科,江苏淮安223000 [3]中国人民解放军第82医院肿瘤科,江苏淮安223000

出　　处：《中华医院感染学杂志》2018年第23期3557-3560,共4页Chinese Journal of Nosocomiology

基　　金：2012年江苏省基础研究计划(自然科学基金)资助项目(BK2012666).

摘　　要：目的探讨非小细胞肺癌(NSCLC)放化疗患者医院感染病原菌特点和相关影响因素。方法选择医院2013年1月-2016年12月期间收治的NSCLC放化疗患者260例。进行细菌培养和鉴定及调查患者临床资料。应用单因素和多因素Logistic回归分析独立影响因素。结果NSCLC放化疗260例患者中,医院感染31例(11.92%),且以呼吸道感染为主,13例占41.94%;NSCLC放化疗医院感染31例共分离出43株病原菌,其中27株革兰阴性菌占62.79%、14株革兰阳性菌占32.56%;多因素Logistic回归分析结果显示,年龄、肿瘤分期、营养不良、吸烟、侵入性操作、住院时间以及预防性抗菌药物为影响NSCLC放化疗医院感染相关危险因素(P<0.05)。结论 NSCLC放化疗患者医院感染病原菌以革兰阴性菌为主,且发生医院感染受多因素影响,因此为降低感染率需合理应用抗菌药物及采取针对性预防措施。OBJECTIVE To investigate the characteristics and influencing factors of nosocomial infection pathogens in patients with non-small cell lung cancer(NSCLC)undergoing chemoradiotherapy.METHODS The 260 cases of NSCLC patients undergoing chemotherapy and radiotherapy admitted to our hospital during Jan.2013 to Dec.2016 were selected.Bacterial culture and identification were conducted,and clinical data of the patients were investigated.Univariate and multivariate logistic regression were used to analyze the independent risk factors.RESULTS Among the 260 cases of NSCLC patients,31 cases(11.92%)had nosocomial infection,dominated by respiratory tract infection,with 13 cases accounting for 41.94%.From the 31 cases of nosocomial infection,43 strains of pathogenic bacteria were isolated,among which 27 strains were gram-negative bacteria accounting for 62.79%,and 14 strains were gram-positive bacteria accounting for 32.56%.Multivariate logistic regression analysis showed that age,tumor stage,malnutrition,smoking,invasive procedures,length of hospital stay and prophylactic antibiotics were the risk factors for nosocomial infection in NSCLC patients(P<0.05).CONCLUSIONGram-negative bacteria are the main pathogens of nosocomial infection in patients with NSCLC undergoing radiotherapy and chemotherapy,and nosocomial infection is affected by many factors.Therefore,rational use of antibiotics and targeted preventive measures are needed to reduce the infection rate.

关 键 词：非小细胞肺癌 放化疗 医院感染 病原菌 影响因素 

分 类 号：R181.3[医药卫生—流行病学]