恶性肿瘤患者放化疗后真菌感染的耐药性分析  

Drug resistance analysis of fungal infections following chemotherapy for malignant tumors

作　　者：冯桂青[1] 许宗磊[1] 肖玉荣[1] 王宝中[1] 张伟红[1] 

机构地区：[1]聊城市人民医院肿瘤科,山东聊城252000

出　　处：《中华医院感染学杂志》2014年第19期4790-4792,共3页Chinese Journal of Nosocomiology

基　　金：山东省聊城市科技局基金资助项目(JB2010卫-3(B)-24-5)

摘　　要：目的探讨恶性肿瘤患者放化疗后真菌感染的相关因素及耐药性,为临床合理治疗和护理提供参考。方法选择2010年2月-2013年2月医院收治的220例恶性肿瘤经放化疗治疗的患者作为研究组,另选择同期非恶性肿瘤住院患者220例作为对照组,对恶性肿瘤患者真菌感染进行调查分析,探讨其危险因素和耐药性特征等,数据均采用SPSS 17.0统计软件进行处理。结果 220例恶性肿瘤患者发生真菌感染42例,感染率为19.1%,220例非恶性肿瘤患者真菌感染18例,感染率为8.2%,差异有统计学意义(P<0.05);42例恶性肿瘤患者真菌感染部位以呼吸道感染率最高为54.8%;年龄、临床分期、住院时间、广谱抗菌药物和激素使用等均为恶性肿瘤患者真菌感染的危险因素;恶性肿瘤患者感染真菌对酮康唑的耐药率最高为28.6%,对伊曲康唑的耐药率略低为16.7%。结论恶性肿瘤患者放化疗后具有较高的真菌感染率,且真菌感染的发生部位多为呼吸道感染,年龄、临床分期、住院时间等为真菌感染的重要危险因素,临床上应针对药敏试验结果进行合理用药,较大程度上降低恶性肿瘤放化疗后的真菌感染率,有利于改善患者的预后。OBJECTIVE To investigate the relevant factors and drug resistance of fungal infections following chemotherapy for malignant tumors so as to provide reference for reasonable clinical treatment and nursing.METHODS Totally 220 hospitalized cancer patients treated by radiotherapy and chemotherapy during Feb.2010 to Feb.2013 were taken as the study group,and 220 patients with non-malignances of the same period as the control group.The analysis of fungal infections following chemotherapy for malignant tumors was conducted to investigate the risk factors and resistance.Data were processed with SPSS 17.0software.RESULTS The number of cases of fungal infections in patients with malignant tumor was 42 and the incidence was 19.1%,in contrast,the number of cases of fungal infections in patients with non-malignance was 18 with the incidence of 8.2%,with significant difference（P〈0.05）.In the 42 cases of fungal infections,the rate of respiratory infection was the highest,up to54.8%.Age,clinical stage,duration of hospitalization,use of broad-spectrum antibiotics and hormones were risk factors for fungal infections in malignant tumor patients.Fungi for infection in patients with malignant tumor had a highest resistance of 28.6%to ketoconazole,and a lower resistance of 16.7%to itraconazole.CONCLUSIONS Patients with malignant tumor have a high fungal infection rate after chemotherapy,the fungal infected site is mostly respiratory tract.Age,clinical stage,duration of hospitalization and so on are important risk factors for fungal infections,clinical susceptibility testing should be carried out for the rational use of drugs,so as to reduce fungal infections after chemotherapy to a large extent,and improve patients＇ outcomes.

关 键 词：恶性肿瘤 放化疗 真菌感染 耐药性 

分 类 号：R181.32[医药卫生—流行病学]