头颈部晚期肿瘤患者感染病原菌分布及药敏结果分析

Distribution and drug resistance of common pathogenic bacteria in patients with head and neck cancer

目的分析156株头颈部晚期肿瘤患者分离病原菌的分布及耐药情况,为临床合理用药和控制医院感染提供依据。方法从肿瘤患者送检各类标本中分离病原菌,K-B纸片法进行药敏试验,分析药敏结果。结果 330例头颈晚期肿瘤患者共分离病原菌156株,感染率47.27%;其中革兰阴性菌感染71株(占45.51%),真菌54株(占34.62%),革兰阳性菌31株(占19.87%);痰液和咽拭子标本共检出95株病原菌,占病原菌总数的60.90%;住院时间超过30d的患者,病原菌感染率为94.55%,住院超过40d的患者感染率为100%。主要革兰阴性菌对亚胺培南、阿米卡星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦敏感;白色念珠菌对氟康唑耐药率较高;革兰阳性菌对万古霉素、亚胺培南、氯霉素敏感。结论引起肿瘤患者医院感染的病原菌多为条件致病菌,常为多重耐药;加强其病原菌分布及耐药性监测,对指导临床合理用药,减少多重耐药菌产生,降低医院感染率具有重要意义。

Objectives To determine the distribution and drug resistance of common pathogenic bacteria in patients with head and neck cancer and provide evidence to guide the rational clinical use of antibiotics and decrease nosocomial infections.Methods Pathogenic bacteria were isolated from patients with a tumor and a nosocomial infection.The K-B disc diffusion method was used to conduct sensitivity testing.The rate of drug resistance in pathogenic bacteria was analyzed. Results A total of 156 pathogens were isolated from 330 patients with cancer.Of 156 clinical isolates,45.51% were Gram-negative bacilli,34.62% were fungi,and 19.87% were Gram-positive cocci.Ninety-five bacterial strains were isolated from sputum and throat swabs,accounting for 60.90% of all pathogens.Principal Gram-negative bacilli were susceptible to imipenem,amikacin,cefoperazone/sulbactam,and piperacillin/tazobactam,and principal Gram-positive cocci were susceptible to vancomycin,imipenem,and chloramphenicol.Candida albicans was highly resistant to fluconazole. Conclusion The principal pathogens that caused nosocomial infections in patients with a tumor were conditioned pathogenic bacteria.Pathogenic bacteria are typically multidrug-resistant.Monitoring pathogenic bacteria could help to reduce multidrug-resistant bacteria and decrease nosocomial infections.