48例癌症化疗病人的感染菌谱分析

THE ANALYSIS OF THE SPECTRUM OF INFECTIOUS BACTERIA IN 48 CASES OF CANCER PATIENTS WITH CHEMOTHERAPY

本文对近年部份癌症病人(包括造血系统恶性肿瘤和实体癌)在化疗期间合并机会菌感染的病原菌谱进行分析。48例病人共发生68例次感染。常见的感染部位有败血症、口咽部和肺。G(一)杆菌是主要的分离菌,占62.5％,主要有大肠杆菌、克雷伯氏菌属、绿脓杆菌;G(+)球菌占34.7％,主要有金黄色葡萄球菌、表皮葡萄球和微球菌属;G(+)杆菌仅占2.8％,包括枯草杆菌和假白喉杆菌各1株。 对41例全身中毒症状明显,或局部感染严重,有全身扩散趋势,同时外周血WBC减少的病人,均尽早联合使用抗菌素治疗,一般用:Aminoglycoside+Ampicillin/carbenicillin或Aminoglycoside+PG,或Aminoglycoside+Cephalosporin。本组10例人死于感染。最主要的致死性感染的败血症(7)例,败血症病人总的病死率为41.2％。

48 cancer patients with 68 episodes of bacterial infections following chemotherapy were reviewed. The underlying diseases included both leukemia-lymphoma and various solid tumors. The common infective sites included septicemia, oral-pharyngeal infection and lung infections. The majority of infections were caused by G negative baci-lli(62.5%), which included E. coli, klebsiellae and pseudomonas aeruginosa etc; 34.7% of the isolated bacteria was G positive cocci which included staphylococci, streptococcus viridans and micrococci; while G(+) bacilli were isolated only in 2 occassions. (2.8%). 41 cases with severe infections were treated with combination of antibiotics, usually Aminogrycoside+Ampicillin/Carbenicillin or Aminoglycoside+PG, or Aminoglycoside+Cepa-losporine. 10 cases died of infections, with septicemia (7) being the major fatal form of infection. The mortality rate of septicemia was 41.2%.