肺癌患者医院感染流行病学特点、病原菌分布及药物敏感性研究  

Epidemiological characteristics,pathogen distribution,and drug sensitivity of hospital acquired lung cancer infections

作　　者：王英[1] 孔芝 刘凤娟 王鹏飞[3] WANG Ying;KONG Zhi;LIU Fengjuan;WANG Pengfei(Department of Nosocomial Infection Control,University of Health and Rehabilitation Sciences,Qingdao Cancer Hospital,Qingdao,Shandong 266042,China;ICU,University of Health and Rehabilitation Sciences,Qingdao Cancer Hospital,Qingdao,Shandong 266042,China;Department of Respiratory and Criticalcare Medicine,Qingdao Central Hospital,University of Health and Rehabilitation Sciences,Qingdao Cancer Hospital,Qingdao,Shandong 266042,China)

机构地区：[1]康复大学青岛中心医院/青岛市肿瘤医院感染管理科,山东青岛266042 [2]康复大学青岛中心医院/青岛市肿瘤医院重症医学科,山东青岛266042 [3]康复大学青岛中心医院/青岛市肿瘤医院呼吸与危重症医学科,山东青岛266042

出　　处：《临床肺科杂志》2025年第4期526-530,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨肺癌患者医院感染的流行病学特点、病原菌分布及耐药性,并分析其与白细胞介素-27(IL-27)基因多态性的关联。方法回顾性分析364例2021年1月-2023年3月康复大学青岛中心医院收治的肺癌患者的临床资料,根据是否发生医院感染分为感染和未感染组,分别为52和312例。分析肺癌患者医院感染患者的病原菌分布及耐药性,比较感染组和未感染组的临床资料及IL-27基因多态性分布情况。结果52例感染者共检出59株病原菌,其中革兰阳性菌18株、真菌2株、革兰阴性菌39株,占比分别为30.51%、3.39%、66.10%。39株革兰阴性菌以肺炎克雷伯菌、铜绿假单胞菌占比较高,二者对头孢曲松、头孢唑林、氨苄西林的耐药率较高。18株革兰阳性菌以金黄色葡萄球菌占比较高,其对氨苄西林、青霉素、环丙沙星的耐药株数较多。感染组肿瘤分期为Ⅲ~Ⅳ期、合并糖尿病、有营养不良、有侵入性操作患者占比及IL-27964 AA基因型、A等位基因频率均高于未感染组(P<0.05)。结论革兰阴性菌为肺癌医院感染患者主要致病菌不同病原体对抗菌药物的耐药特点不同,且其发生医院感染可能与肿瘤分期为Ⅲ~Ⅳ期、合并糖尿病、有营养不良、有侵入性操作及IL-27964 AA基因型有关。Objective To investigate the epidemiological characteristics,pathogen distribution,and drug resistance of hospital acquired infections in lung cancer patients,and to analyze their association with interleukin-27(IL-27)gene polymorphism.Methods The clinical data of 364 patients with lung cancer admitted to Qingdao Central Hospital from January 2021 to March 2023 were retrospectively analyzed.They were divided into the infection and uninfected group according to whether they had hospital infection,with 52 and 312 cases.The distribution and drug resistance of pathogens in lung cancer hospital infected patients were analyzed,and the clinical data and the distribution of IL-27 gene polymorphism between the infected and uninfected groups were compared.Results A total of 59 pathogenic bacteria were detected in 52 infected individuals,including 18 strains of Gram positive bacteria,2 strains of fungi,and 39 strains of Gram negative bacteria,accounting for 30.51%,3.39%and 66.10%,respectively.Among the 39 strains of Gram negative bacteria,Klebsiella pneumoniae and Pseudomonas aeruginosa accounted for a relatively high proportion,and both had a higher resistance rate to ceftriaxone,ceftriaxone,and ampicillin.Among the 18 strains of Gram positive bacteria,Staphylococcus aureus accounted for a relatively high proportion,and it had a higher resistance to ampicillin,penicillin,and ciprofloxacin.The proportion of patients with tumor stageⅢ~Ⅳ,diabetes,malnutrition and invasive operation and frequencies of IL-27964 AA genotype and A Allele frequency in the infected group were higher than those in the uninfected group(P<0.05).Conclusion The pathogens of hospital infection in patients with lung cancer are mainly gram-negative bacteria,different pathogens have different characteristics of resistance to antibiotics,and the occurrence of nosocomial infection may be related to the tumor stageⅢ~Ⅳ,combined with diabetes,malnutrition,invasive procedures,and IL-27964 AA genotype.

关 键 词：肺癌 白细胞介素-27 基因多态性 医院感染 病原菌 耐药性 

分 类 号：R734.2[医药卫生—肿瘤] R446.5[医药卫生—临床医学]