肺癌住院患者合并医院感染的临床分析

Clinical analysis of nosocomial infection in patients with lung cancer

目的探讨肺癌住院患者发生医院感染的病原菌分布及年度动态变迁。方法对456例肺癌患者住院期间发生医院感染的情况进行回顾性分析。结果 456例肺癌患者发生医院感染104例,医院感染率22.8%,小细胞肺癌更容易发生医院感染。感染部位以呼吸道和口腔为主,占83.1%。分离病原菌203株,其中革兰阴性杆菌(G-菌)占49.8%,以肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌为主;其次为革兰阳性球菌(G+菌),占27.6%,以金黄色葡萄球菌、表皮葡萄球菌为主;真菌居第3位,占22.6%,以白色假丝酵母菌为主。从5年感染率的变化趋势来看,真菌感染有明显上升趋势。结论肺癌患者是医院感染的易感人群,合并感染的病原菌大多为条件致病菌,感染发生率高。真菌感染上升趋势明显,应引起重视。动态监测临床患者的感染情况,可为临床抗感染治疗提供依据。

Objective To investigate the clinical characteristics of nosocomial infection,especially distribution and yearly changes of the pathogens,in the inpatients with lung cancer.Methods The clinical information and data of 456 cases of inpatients with lung cancer were retrospectively analysised.Results Among 456 cases of lung cancer,104 cases suffered from nosocomial infection,with the infection rate of 22.8%.The cases of small-cell lung cancer were more prone to suffer from nosocomial infection.The respiratory tract and oral cavity were the most frequent infection sites（83.1%）.Totally 203 pathogenic strains were isolated from sputum.49.8% of the pathogens were the Gram-negative bacteria mainly including Klebsiella pneumonia,Escherichia coli,Pseudomonas aeruginosai,27.6% of the pathogens were Gram-positive bacteria mainly including Staphylococcus aureus and Staphylococcus epidermidis,and the rest 22.6% of the infection was caused by different kinds of fungi dominated by Saccharomyces albicans.The infection caused by fungi was obviously increased in the past 5 years.Conclusion The lung cancer inpatients are the susceptible population of nosocomial infection.Most pathogenic bacteaia in complicasting infection infection were conditional bacteria with the high incidence rate.Fungal infection has an increasing trend,which should be paid attention to.Dynamic monitoring infection in the clinical patients can provide the basis for clinical anti-infection therapy.