胃癌术后肺部感染影响因素和病原菌分布及其耐药性  

Influencing factors for postoperative pulmonary infection in gastric cancer patients,distribution and drug resistance of pathogens

作　　者：余喜梅[1] 高红梅 YU Xi-mei;GAO Hong-mei(The First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan 47300,China;不详)

机构地区：[1]南阳医学高等专科学校第一附属医院肿瘤科,河南南阳473000 [2]信阳市中心医院肿瘤科,河南信阳464000

出　　处：《中华医院感染学杂志》2022年第17期2638-2641,共4页Chinese Journal of Nosocomiology

基　　金：河南省科技攻关计划基金资助项目(2018020987)。

摘　　要：目的分析胃癌术后肺部感染影响因素和病原菌分布及其耐药性。方法选取2019年1月-2020年1月南阳医学高等专科学校第一附属医院肿瘤科收治的行腹腔镜胃癌根治术患者326例,根据术后是否出现肺部感染分为感染组和非感染组。收集两组患者临床资料,单因素及多因素Logistic回归分析肺部感染影响因素;采集感染组患者痰液样本,进行病原菌分离及药敏试验。结果326例行腹腔镜胃癌根治术患者术后发生肺部感染86例,感染率为26.38%;多因素Logistic回归分析结果显示,年龄≥60岁、吸烟史、高血压、糖尿病、手术时间≥240 min、术中出血量≥200 ml是胃癌患者术后发生肺部感染的独立影响因素(P<0.05);86例感染患者痰标本共分离出106株病原菌,其中革兰阴性菌63株占59.43%,革兰阳性菌34株占32.08%,真菌9株占8.49%。药敏试验结果显示,万古霉素对金黄色葡萄球菌和溶血葡萄球菌具有较低的耐药性;头孢哌酮和亚胺培南对肺炎克雷伯菌、铜绿假单胞菌及大肠埃希菌具有较低的耐药性。结论年龄、吸烟史、高血压、糖尿病、手术时间及术中出血量是胃癌患者术后发生肺部感染的影响因素,革兰阴性菌是胃癌患者术后肺部感染的主要病原菌。OBJECTIVE To investigate the influencing factors for postoperative pulmonary infection in gastric cancer patients and analyze the distribution and drug resistance of pathogens.METHODS From Jan 2019 to Jan 2020,totally 326 gastric cancer patients who underwent laparoscopic radical surgery and were treated in oncology department of the First Affiliated Hospital of Nanyang Medical College were enrolled in the study and were divided into the infection group and the no infection group according to the status of postoperative pulmonary infection.The clinical data were collected,univariate analysis and multivariate logistic regression analysis were performed for influencing factors for the pulmonary infection.The sputum specimens were collected from the patients of the infection group,the pathogens were isolated,and the drug susceptibility testing was carried out.RESULTS Among the 326 gastric cancer patients who underwent laparoscopic radical surgery,86 had postoperative pulmonary infection,with the infection rate 26.38%.The result of multivariate logistic regression analysis showed that the no less than 60 years of age,smoking history,hypertension,diabetes mellitus,operation duration no less than 240 min and intraoperative bleeding volume no less than 200 ml were the independent influencing factors for the postoperative pulmonary infection in the gastric cancer patients(P<0.05).Totally 106 strains of pathogens were isolated from the sputum specimens of the 86 patients with infection,63(59.43%)of which were gram-negative bacteria,34(32.08%)were gram-positive bacteria,and 9(8.49%)were fungi.The result of drug susceptibility testing indicated that the drug resistance rate of Staphylococcus aureus and Staphylococcus haemolyticus to vancomycin was low,and the drug resistance rates of Klebsiella pneumoniae,Pseudomonas aeruginosa and Escherichia coli to cefoperazone and imipenem were low.CONCLUSION The age,smoking history,hypertension,diabetes mellitus,operation duration and intraoperative bleeding volume are the influencing

关 键 词：胃癌 肺部感染 影响因素 病原菌 耐药性 

分 类 号：R735.2[医药卫生—肿瘤]