头颈部恶性肿瘤患者医院感染回顾性分析  

Retrospective analysis on nosocomial infection in the patients with head and neck malignant tumors

作　　者：万璐颖 谢贤和[1] WAN Luying;XIE Xianhe(No.2 Zone of Chemotherapy,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350000,China)

机构地区：[1]福建医科大学附属第一医院化疗二区,福建福州350000

出　　处：《中国现代医生》2018年第31期25-28,32,共5页China Modern Doctor

摘　　要：目的分析头颈部恶性肿瘤患者医院感染情况、常见致病菌和药敏结果,为临床防治提供依据。方法收集2016年1月1日～2017年12月31日期间我院头颈部恶性肿瘤合并医院感染患者220例,分析患者临床资料、感染部位、病原菌种类及抗菌药物耐药情况。结果 220例头颈部恶性肿瘤患者中培养阳性者113例,共培养出病原菌158株,其中革兰阴性菌124株占78.5%,革兰阳性菌25株占15.8%,真菌9株占5.7%。G-菌中铜绿假单胞菌占比最高(24.7%),对亚胺培南耐药率最高,为17.9%。G+菌以金葡菌为主(8.9%),对青霉素G耐药率最高,为85.7%。医院感染部位以下呼吸道感染为主(61.8%),其次为手术切口感染(33.2%)。结论头颈部恶性肿瘤患者医院感染时以G-菌为主,临床应根据药敏结果合理规范使用抗生素以提高疗效。Objective To analyze the nosocomial infection, common pathogens and drug susceptibility results of patients with head and neck malignant tumors, so as to provide evidence for clinical prevention and treatment. Methods 220 patients with head and neck malignant tumors complicated with nosocomial infections were collected from January 1, 2016 to December 31, 2017. The patient＇s clinical data, infection site, pathogen species and antimicrobial resistance were analyzed. Results Of the 220 patients with head and neck malignant tumors, 113 were positive in culture. A total of 158 strains of pathogenic bacteria were cultivated. Among them, 124 strains of Gram-negative bacteria accounted for 78.5%, 25 strains of Gram-positive bacteria accounted for 15.8%, and 9 strains of fungi accounted for 5.7%. Among the G-negative bacteria, Pseudomonas aeruginosa had the highest proportion （24.7%）, and it had the highest resistance rate to imipenem, which was 17.9%. Among the G-positive bacteria, Staphylococcus aureus was the majority（8.9%）, and it had the highest resistance rate to penicillin G, which was 85.7%. Respiratory infections were predominant in nosocomial infections（61.8%）, followed by surgical incision infections（33.2%）. Conclusion G-negative bacteria is the main strain in nosocomial infection in the patients with head and neck malignant tumors. Clinically, antibiotics should be used according to the results of drug susceptibility to improve the efficacy.

关 键 词：头颈部恶性肿瘤 感染 抗菌药物 耐药 

分 类 号：R739.91[医药卫生—肿瘤]