159例肺癌患者化疗后肺部感染标本中致病菌的分布及其耐药性分析  

Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Specimens of 159 Lung Cancer Patients with Pulmonary Infection after Chemotherapy

作　　者：朱泽文[1] ZHU Ze-wen(Department of Oncology,Pingxiang People's Hospital,Pingxiang Jiangxi 337000,China)

机构地区：[1]萍乡市人民医院肿瘤科,江西萍乡337000

出　　处：《抗感染药学》2021年第8期1114-1117,共4页Anti-infection Pharmacy

摘　　要：目的:分析肺癌患者化疗后肺部感染痰液标本中致病菌的临床分布及其对抗菌药物的耐药情况。方法:选取医院2018年1月—2020年8月收治的肺癌患者化疗后肺部感染159例病历资料,统计其呼吸道深处痰液标本的细菌培养及其药敏试验结果,分析其致病菌的分布情况及主要致病菌的耐药特点。结果:159例肺癌患者化疗后肺部感染标本中分离出致病菌202株,其中革兰阳性菌56株(占27.72%)、革兰阴性菌114株(占56.44%)和真菌32株(占15.84%);革兰阳性菌中金黄色葡萄球菌对青霉素、克林霉素的耐药率较高,对左氧氟沙星、复方磺胺甲噁唑、莫西沙星的耐药率较低,粪肠球菌对青霉素、克林霉素、庆大霉素的耐药率较高,对复方磺胺甲噁唑的耐药率较低,凝固酶阴性葡萄球菌对青霉素、克林霉素、庆大霉素的耐药率较高,对苯唑西林、复方磺胺甲噁唑的耐药率较低,三者对万古霉素均无耐药;革兰阴性菌中铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌对氨苄西林、头孢哌酮、头孢唑林的耐药率均较高,而对阿米卡星、亚胺培南的耐药率较低;真菌中白假丝酵母对各抗真菌药物的耐药率均较低。结论:肺癌患者化疗后肺部感染病原菌以革兰阴性菌为主,但各病原菌的耐药率各不相同,临床应根据药敏结果合理选用敏感率高的抗菌药物治疗,以保障肺癌患者化疗的正常进行。Objective: To analyze the clinical distribution of pathogenic bacteria in sputum specimens of lung cancer patients after chemotherapy and their resistance to antibacterial agents. Methods: Medical records of 159 cases of lung cancer patients treated in our hospital from January 2018 to August 2020 with pulmonary infection after chemotherapy were selected. The bacterial culture and drug sensitivity test results of sputum specimens in deep respiratory tract were statistically analyzed, and the distribution of pathogenic bacteria and the drug resistance characteristics of main pathogenic bacteria were analyzed. Results: 202 strains of pathogenic bacteria were isolated from the lung infection samples of 159 lung cancer patients after chemotherapy, including 56 strains(27.72%) of Gram-positive bacteria, 114 strains(56.44%) of Gram-negative bacteria and 32 strains(15.84%) of fungi. In the Gram-positive bacteria, Staphylococcus aureus showed higher resistance rates to penicillin and clindamycin, while the resistance rates to levofloxacin, compound sulfamethoxazole and moxifloxacin were lower. Enterococcus faecalis showed higher resistance rates to penicillin,clindamycin and gentamicin, while the resistance rates to compound sulfamethoxazole were lower. The drug resistance rates of Coagulase-negative Staphylococcus to penicillin, clindamycin and gentamicin were higher, while the drug resistance rates to oxacillin and compound sulfamethoxazole were lower, and no drug resistance to vancomycin was found. In the Gram-negative bacteria, Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli had higher drug resistance rates to ampicillin, cefoperazone and cefazolin, but lower drug resistance rates to amikacin and imipenem. The resistance rate of Candida albicans to all antifungal agents was low. Conclusion: The main pathogens of pulmonary infection in lung cancer patients after chemotherapy were Gram-negative bacteria, but the drug resistance rate of each pathogen was different. Therefore, clinical use of antibacte

关 键 词：肺癌 肺部感染 致病菌 耐药性 

分 类 号：R915[医药卫生—微生物与生化药学] R969.3[医药卫生—药学]