老年非小细胞肺癌患者化疗后感染病原菌耐药性与易感因素分析  

Drug resistance of pathogenic bacteria and risk factors of the infections after chemotherapy in elderly patients with non-small cell lung cancer

作　　者：陆珊珊[1] 陈晨[1] 孙路 刘怡妍[1] 赵静[1] 

机构地区：[1]复旦大学附属肿瘤医院心肺功能科,上海200032 [2]上海市杨浦区控江社区卫生服务中心全科,上海200093

出　　处：《中华医院感染学杂志》2015年第23期5329-5331,共3页Chinese Journal of Nosocomiology

基　　金：上海市自然科学基金资助项目(12ZR1402800)

摘　　要：目的探讨老年非小细胞肺癌(NSCLC)患者化疗后感染的特点及病原菌耐药性,为老年肺癌患者感染的预防治疗提供参考。方法回顾性分析2013年1月-2015年4月收治的406例老年NSCLC患者,对化疗后发生感染患者进行细菌培养及药敏试验,总结感染的病原学特点,数据采用SPSS 17.0软件进行统计分析。结果共44例患者发生感染,感染率为10.84%;共检出病原菌72株,革兰阴性菌50株占69.44%,革兰阳性菌19株占26.39%,真菌3株占4.17%;革兰阴性菌对庆大霉素、磺胺甲噁唑/甲氧苄啶等耐药,耐药率均>80.00%,而对亚胺培南、美罗培南敏感率分别为100.00%、97.78%;男性、高龄、置管及住院时间长、化疗诱导期是医源性感染的易感因素(P<0.05)。结论男性、高龄、置管及住院时间长、化疗诱导期是医源性感染的易感因素,临床应加大对易感患者的重视,并根据药敏试验选择适宜抗菌药物,提高治疗效率。OBJECTIVE To investigate the characteristics of infections after chemotherapy in elderly patients with NSCLC, so as to provide a reference for the prevention and treatment of the infections. METHODS Totally 406 pa- tients with NSCLC underwent chemotherapy from Jan. 2013 to Apr. 2015, were chosen as study objects. The bacteria culture and drug sensitivity test were conducted to patients who got infected after chemotherapy. Etiologic features were summed up and all data were statistically analyzed by SPSS 17.0. RESULTS A total of 44 patients were infected, and the infection rate was 10.84%. Among them, 72 strains o{ pathogens were found out, inclu- ding 50 strains of gram-negative bacteria （69.44 %）, 19 strains of gram-positive bacteria （26.39%） and 3 strains of fungi （4.17%）. Gram-negative bacteria were resistant to gentamicin, sulfamethoxazole/trimethoprim with the drug resistance rate over 80.00%. However, they were 100% sensitive to imipenem and 97. 78% sensitive to meropenem. Male, age, catheter indwelling and long hospital stay, chemotherapy induction period were iatrogenic risk factors for the infections（P〈0.05）, CONCLUSION Importance should be attached to susceptible patients in clinical practices and antibiotics should be rationally chosen according to drug sensitivity test to improve the cura- tive effect.

关 键 词：非小细胞肺癌 感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]