鼻咽癌住院患者医院感染病原菌特点及相关因素分析

Pathogenic characteristics and related factors of nosocomial infection in inpatients with nasopharyngeal carcinoma

目的探讨鼻咽癌住院患者医院感染病原菌特点及相关因素。方法回顾性分析1633例鼻咽癌患者的临床资料。结果有48例患者发生医院感染,鼻咽癌住院患者医院感染率为2.9%;共发生51个部位感染,以口腔黏膜感染为主,占62.7%,其次为颈部皮肤,占23.5%;共分离出51株病原菌,真菌占66.7%,以白色假丝酵母菌,占51.0%,革兰阴性菌占23.5%,革兰阳性菌占9.8%;单因素χ2检验显示年龄、手术、放化疗、住院时间、抗菌药物使用情况和肿瘤分期是鼻咽癌患者发生医院感染的危险因素(P<0.05)。结论鼻咽癌医院感染以真菌感染为主,应缩短鼻咽癌患者的住院时间,做好口腔护理工作,选用合理的抗菌药物,放化疗时应密切监测不良反应。

OBJECTIVE To study the pathogen characteristics and related factors of nosocomial infection of the inpatients with nasopharyngeal carcinoma.METHODS The clinical data of 1633 inpatients with nasopharyngeal carcinoma were retrospectively analyzed.RESULTS A total of 48 cases were infected and the infectious rate was 2.9%.51 sites were infected.The oral mucosal membrane was the main infectious area,accounting for 62.7%,and the second was neck skin,accounting for 23.5%.A total of 51 strains of pathogen were isolated,of which 34 strains were fungi,accounting for 66.7%,12 strains of Gram-negative bacteria,accounting for 23.5%,and 5 strains of Gram-positive bacteria,accounting for 9.8%.The isolation rate of Candida albicans was predominant,accounting for 51.0%.The correlation analysis showed that nosocomial infections were closely related to the age,operation,radiotherapy and chemotherapy,hospital stay,antibiotic application and TNM-staging（P〈0.05）.CONCLUSION Fungal infections are very common of the inpatients with nasopharyngeal carcinoma.We should shorten the hospital stay,reinforce the oral nursing,reasonably use antibiotics and closely monitor the adverse reactions during the radiotherapy and chemotherapy.