恶性肿瘤医院感染的临床分析

Nosocomial Infection Cases with Malignant Tumor: A Clinical Investigation

目的 探讨恶性肿瘤并发医院感染特点及预后。方法 回顾调查我院近 3年收治的恶性肿瘤 (包括恶性血液病 )并发医院感染的 12 8例患者的基本情况 ,细菌培养结果及抗感染治疗的临床疗效。结果 恶性肿瘤患者医院感染多见于急性白血病、肺癌 ,好发部位为呼吸道、血液、口腔、泌尿道等 ,导致感染的病原菌以 G- 菌为主占4 7.2 % ,G- 菌对亚胺培南 /西司他丁 (泰能 )、阿米卡星较敏感 ,G+ 菌对万古霉素、环丙沙星较敏感。结论 恶性肿瘤医院感染的病原菌多见于条件致病菌 ,耐药率较高 ,积极控制原发病 ,预防化、放疗所致的白细胞下降 。

OBJECTIVE To investigate the characters and prognosis of nosocomial infection patients with malignant tumors. METHODS There were 128 cases of nosocomial infection with malignant tumor (included hematological malignancies) being analysed. RESULTS Nosocomial infection occurred mainly in patients with acute leukemia and lung cancer. The respiratory tract was the most frequent infection site followed by blood, oral cavity and urinary tract. The most common pathogen was the Gram negative bacilli (47.2%) which were relatively sensitive to imipenem, amikacin and ceftazidine. The Gram positive cocci were relative sensitive to vancomycin and ciprofloxacin. CONCLUSIONS The conditioned pathogenic bacteria were the main pathogens in nosocomial infection with malignant tumor and most of them resisted to antibiotics. Giving an efficacious regimen for control tumor and preventing the neutropenia followed by chemotherapy is good to control nosocomial infection in patients with malignant tumor.