非小细胞肺癌病例术后呼吸道感染病原微生物分布及耐药性分析  

Distribution of pathogenic microorganisms causing respiratory infections and analysis of antimicrobial resistance among non-small-cell lung cancer patients following surgery

作　　者：叶晟劼 吴智明 王包晟 蒋磊 YE Shengjie;WU Zhiming;WANG Baosheng;JIANG Lei(Department of Thoracic Surgery,Yiring ditional Chinese Medicine Hospital,Yiring,Jiangsu 214200,China)

机构地区：[1]江苏省宜兴市中医医院胸外科,江苏宜兴214200

出　　处：《中国病原生物学杂志》2025年第5期638-641,共4页Journal of Pathogen Biology

基　　金：江苏省无锡市科协软科学研究课题(No.KX-24-C314)。

摘　　要：目的分析非小细胞肺癌术后呼吸道感染病例为微生物种群构成,测定其对抗生素的敏感性,从而为制定有针对性的治疗方案、改善患者预后提供参考依据。方法采集行肺叶切除术后发生呼吸道感染的157例非小细胞肺癌病例痰液、肺泡灌洗液、胸水等临床样本用于病原菌培养和鉴定,并进行药敏试验,全部数据采用R 4.4.1软件包进行描述性统计分析。结果共分离、培养、鉴定出病原微生物2类162株,其中细菌161株、真菌1株,其中革兰阴性菌120株(74.07%)、革兰阳性菌41株(25.31%),肺炎克雷伯菌为分离的最主要革兰阴性菌,金黄色葡萄球菌为分离的最主要革兰阳性菌。革兰阴性菌中,肺炎克雷伯菌对氨苄西林、氨苄西林/舒巴坦、头孢唑啉耐药率较高,鲍曼不动杆菌对氨苄西林、氨苄西林/舒巴坦、头孢唑啉、氨曲南耐药率较高,铜绿假单胞菌对氨苄西林、氨苄西林/舒巴坦、头孢唑啉、头孢曲松、复方新诺明耐药率较高;革兰阳性菌中,金黄色葡萄球菌对利奈唑胺、呋喃妥因、利福平耐药率较低。结论革兰阴性菌为非小细胞肺癌术后呼吸道感染的主要病原微生物;肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌等革兰阴性菌对氨苄西林、氨苄西林/舒巴坦、头孢唑啉耐药率较高,而金黄色葡萄球菌对利奈唑胺、呋喃妥因、利福平仍较敏感。Objective To analyze the composition of microorganism populations causing respiratory infections among non-small-cell lung cancer patients following surgery and to test the susceptibility of bacterial isolates to antibiotics,so as to provide the evidence for formulating the targeted treatment strategy and improving the patients'prognosis.Methods Sputum,bronchoalveolar lavage fluid,pleural effusion specimens were sampled from 157 non-small-cell lung cancer patients with respiratory infections following lobectomy for pathogen culture and identification,and antimicrobial test was performed.All data were analyzed with a descriptive statistical analysis method using the software R 4.4.1.Results Two species of pathogenic microorganisms were isolated,cultured and identified,including 161 bacterial isolates and one fungal isolate,and the bacterial isolates included 120 Gram-negative bacterial isolates(74.07%)and 41 Gram-positive isolates(25.31%),with Klebsiella pneumoniae as the most common Gram-negative bacterial isolate and Staphylococcus aureus as the most common Gram-positive bacterial isolate.Of the Gram-negative bacterial isolates,K.pneumoniae showed high resistance to ampicillin,ampicillin/sulbactam and cefazolin,and Acinetobacter baumannii showed high resistance to ampicillin,ampicillin/sulbactam,cefazolin and aztreonam,while Pseudomonas aeruginosa showed high resistance to ampicillin,ampicillin/sulbactam,cefazolin,ceftriaxone and compound sulfamethoxazole.Among Gram-positive bacterial isolates,S.aureus showed low resistance to linezolid,nitrofurantoin and rifampicin.Conclusion Gram-negative bacterial isolates are major pathogenic microorganisms causing respiratory infections among non-small-cell lung cancer patients following surgery.Gram-negative bacterial isolates are highly resistant to ampicillin,ampicillin/sulbactam and cefazolin,and S.aureus remains highly susceptible to linezolid,nitrofurantoin and rifampicin.

关 键 词：病原微生物 药敏测定 耐药性 呼吸道感染 非小细胞肺癌 

分 类 号：R446.5[医药卫生—诊断学]