肺癌患者呼吸道感染病原菌种类及耐药情况研究

目的 分析肺癌患者呼吸道感染病原菌种类及耐药情况,为临床抗感染药物的应用提供参考依据。 方法 选取2009年1月至2016年2月北京航天总医院就诊的214例肺癌患者为研究对象,采集标本进行真菌、细菌培养及药敏试验,分析病原菌种类及耐药情况。 结果 214例患者共检出菌株134株。其中革兰阴性杆菌有89株(66.42%),以大肠埃希菌(29.21%)、肺炎克雷伯菌(24.72%)、铜绿假单胞菌(16.85%)和鲍曼不动杆菌(10.11%)为主；共检出革兰阳性球菌19株(14.18%),以溶血葡萄球菌(42.11%)、金黄色葡萄球菌(26.32%)和肺炎链球菌(21.05%)为主；检出真菌26株(19.40%),以白色念珠菌(53.85%)、假丝酵母菌(23.08%)为主。药物试验检测结果显示,革兰阴性杆菌对复方磺胺甲唑、氨苄西林的耐药率均高达80%以上；革兰阳性球菌对万古霉素敏感率为100%,对氨基糖甙类、喹诺酮类、头孢类等药物敏感性低。 结论 肺癌患者的呼吸道抗感染病原菌种类复杂,临床用药必须重视抗菌药物的合理使用,根据药敏结果选择抗菌药物,以提高抗感染的治疗的针对性。

Research on the pathogenic bacteria species and drug resistance in lung cancer patients complicated with respiratory tract infection

Objective To analyze the pathogenic bacteria species and drug resistance in lung cancer patients complicated with respiratory tract infection,and to provide reference for the application of anti-infection agents. Methods Two hundred and fourteen patients with lung cancer treated in Beijing Aerospace General Hospital from January 2009 to February 2016 were selected.The specimens were collected to do the fungus,bacterial culture and drug sensitive test.The pathogenic bacteria species and drug resistance were analyzed. Results There were 134 bacterial strains from 214 cases.Among them,there were 89 strains of Gram negative bacilli (66.42%),which were mainly escherichia coli (29.21%),Klebsiella pneumoniae (24.72%),pseudomonas aeruginosa (16.85%) and Acinetobacter baumannii (10.11%);there were 19 strains of gram-positive cocci (14.18%),mainly including staphylococcus haemolyticus (42.11%),staphylococcus aureus (26.32%) and streptococcus pneumoniae (21.05%);there were 26 strains of fungus (19.40%),mainly including candida albican (53.85%) and candida mycoderma bacteria (23.08%).Based on the drug sensitive test,it was known that the drug resistance rate of gram-negative cocci on paediatric compound sulfamethoxazole tablets and ampicillin was more than 80%;the drug resistance rate of gram-positive cocci on vancomycin was 100% while the drug resistance rates of gram-positive cocci on aminoglycosides,quinolones and cephalosporin were lower. Conclusions For lung cancer patients complicated with respiratory tract infection,the pathogenic bacteria species are much complex.The rational use of antibiotics must be attached great importance to. Antibiotics should be selected according to the drug sensitivity results to improve the targeting of anti-infective treatment.