肺癌伴肺部感染患者痰标本病原分布及药敏试验分析  

Pathogen distribution and drug sensitivity test of sputum specimens from lung cancer patients with pulmonary infection

作　　者：孙兴芝 SUN Xingzhi(Department of Pharmacy of Lankao County Hospital of Traditional Chinese Medicine,Kaifeng 475300 Henan,China)

机构地区：[1]兰考县中医院药剂科,河南开封475300

出　　处：《中国民康医学》2022年第6期1-3,13,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:分析肺癌伴肺部感染患者痰标本病原分布及药敏试验结果,为临床合理使用抗菌药物提供依据。方法:选取2017年5月至2020年5月该院收治的85例肺癌伴肺部感染患者为研究对象,对其痰标本进行细菌学检测,分析病原菌分布和药敏试验结果。结果:85例患者共检出98株病原菌,其中革兰阴性菌52株(53.06%),革兰阳性菌29株(29.59%),真菌17株(17.35%);主要革兰阴性菌中大肠埃希菌、铜绿假单胞菌对氨苄西林、头孢唑啉、头孢曲松的耐药率较高(均超过80%),对亚胺培南、头孢他啶、美罗培南的敏感性较高;主要革兰阳性菌中金黄色葡萄球菌、溶血葡萄球菌对青霉素、氨苄西林的耐药率达100%,仅对三线抗生素万古霉素、利奈唑胺高度敏感。真菌药敏试验结果显示,白色念珠菌对一线抗真菌药物酮康唑耐药率较高。结论:肺癌伴肺部感染患者的痰标本病原菌分布以革兰阴性菌为主,其次是革兰阳性菌和真菌。主要病原菌对常用的青霉素、头孢类抗生素耐药较普遍,二、三线药物也存在一定滥用现象。建议临床实践中根据药敏试验结果合理应用抗生素,以降低病原菌耐药性,保证治疗效果。Objective:To analyze pathogen distribution and drug sensitivity test of sputum specimens from lung cancer patients with pulmonary infection.Methods:85 patients with lung cancer and pulmonary infection who were admitted to our hospital from May 2017 to May 2020were selected as the research objects.The bacteriology detection was performed on the sputum specimens.Then,the pathogen distribution and the drug sensitivity test results were analyzed.Results:98 pathogenic bacteria were detected in the 85 patients,including 52(53.06%)gram-negative bacteria,29(29.59%)gram-positive bacteria and 17(17.35%)fungi.Among the major gram-negative bacteria,Escherichia coli and Pseudomonas aeruginosa had higher resistance rates to Ampicillin,Cefazolin,and Ceftriaxone(all>80%),and were highly resistant to Imipenem,Ceftazidime,and Meropenem.Among the major gram-positive bacteria,Staphylococcus aureus and Staphylococcus haemolyticus were 100% resistant to Penicillin and Ampicillin,and were only highly sensitive to the third-line antibiotics Vancomycin and Linezolid.Fungal susceptibility tests showed that Candida albicans had a high resistance rate to the first-line antifungal drug Ketoconazole.Conclusions:The pathogen distribution in the sputum specimens from the patients with lung cancer and pulmonary infection is mainly gram-negative bacteria,followed by gram-positive bacteria and fungi.The main pathogens are generally resistant to the commonly used Penicillin and Cephalosporins.The second-and third-line drugs are also abused.It is recommended that antibiotics should be rationally used in the clinical practice according to the results of drug sensitivity test to reduce the drug resistance of pathogenic bacteria and ensure the therapeutic effects.

关 键 词：肺癌 肺部感染 痰液标本 药敏试验 抗菌药物 

分 类 号：R563.1[医药卫生—呼吸系统]