舌癌患者根治术后医院感染的病原菌分析  

Pathogenic bacteria causing nosocomial infections after radical resection in tongue cancer patients

作　　者：姜琼丽 张丽梅[1] 陈慧明[1] 王丽[2] 詹燏[3] 

机构地区：[1]湖北省监利县人民医院耳鼻喉科,湖北监利县433300 [2]湖北省新华医院检验科,湖北武汉430015 [3]武汉市中心医院检验科,湖北武汉430014

出　　处：《中华医院感染学杂志》2015年第7期1642-1644,共3页Chinese Journal of Nosocomiology

基　　金：湖北省自然科学基金资助项目(2011CDB501)

摘　　要：目的探讨舌癌患者根治术后医院感染的临床特点、病原菌种类及耐药性,为耳鼻喉科医师控制术后感染挑选敏感的抗菌药物提供参考指南。方法 2006年1月-2013年12月医院共收集1 796例舌癌患者发生临床资料,分析细菌培养阳性116例患者医院感染临床特点及病原菌分布与耐药性,采用WHONET 5.6软件进行统计处理。结果 1 796例舌癌患者发生感染共116例,感染率为6.5%;培养出116株病原菌,以革兰阴性菌为主,共76株占65.5%;大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌对磺胺甲噁唑/甲氧苄啶耐药率最高,均>60.0%;革兰阴性菌对头孢噻肟、环丙沙星、庆大霉素的耐药率均>40.0%。结论舌癌患者根治术后医院感染病原菌的耐药性不断增强,治疗难度不断加大,提示临床医师应增强病原学培养的观念,依据药敏结果,结合患者病情选择高敏感、低价格的抗菌药物控制舌癌根治术后感染。OBJECTIVE To investigate the clinical characteristics,species and drug-resistance of pathogenic bacteria causing nosocomial infections after radical resection in tongue cancer patients and provide the evidence for control of infections and targeted use of antibiotics.METHODS The clinical data were collected from 1 796 tongue cancer patients who were treated in the hospitals from Jan 2006 to Dec 2013,and 116 patients were positive for bacterial culture;the clinical characteristics of nosocomial infections and the drug resistance of pathogens were observed,and the statistical analysis was performed with the use of WHONET 5.6software.RESULTS There were 116 cases of infections in the 1796 patients with the infection rate of 6.5%.Pathogenic bacteria causing nosocomial infections after radical resection in tongue cancer patients mainly was gram-negative bacteria（76strains,65.5%）.Resistance rates of Escherichia coli,Klebsiella pneumonia and Pseudomonas aeruginosa to sulfamethoxazole/trimethoprim were the highest（more than 60%）.The resistant rate of gram-negative bacteria to cefotaxime,ciprofloxacin,and gentamicin was more than 40%.CONCLUSIONDrug-resistance of pathogenic bacteria causing nosocomial infections after radical resection in tongue cancer patients was increasing.The increasing difficulty in treatment suggested that the clinicians should enhance the concept of pathogenic culture and choose antibiotics of high sensitivity and low price to control infections after radical operation in tongue cancer patients according to the results of drug susceptibility.

关 键 词：舌癌 医院感染 病原菌 抗药性 

分 类 号：R619.3[医药卫生—外科学]