非发酵菌致肺癌患者肺部感染的病原学构成与耐药性分析

Etiological composition and resistance of nonfermenters bacteria causing lung infections in patients with lung cancer

目的了解肺癌患者肺部非发酵菌感染的病原学构成及耐药特征,为非发酵菌感染的预防和治疗提供有效依据。方法对本院2009年7月至2014年6月肺癌并发肺部非发酵菌感染的病例进行回顾分析,常规方法培养及鉴定细菌,K-B法检测非发酵菌的耐药率,按CLSI 2013年标准判定药敏结果,用WHONET 5.6软件分析数据,研究其病原菌构成及耐药特征。结果 2009年7月至2014年6月,从本院住院治疗的肺癌合并肺部感染患者中共检出非发酵菌211株,其中铜绿假单胞菌最为常见(42.2%),其次为鲍氏不动杆菌(28.9%)和嗜麦芽寡养单胞菌(20.4%);药敏试验表明4种非发酵菌对常用抗菌药物均有不同程度的耐药甚至多重耐药。结论非发酵菌是导致肺癌合并肺部感染常见病原菌,其耐药率高,治疗困难,临床应高度重视,加强耐药性监测,为临床合理用药,防止继发感染提供依据。

Objective To learn the etiological composition and drug resistance of nonfermenter bacteria from lung infection in patients with lung cancer,and provide evidences for the prevention and treatment of Nonfermenters bacteria infection. Methods The pulmonary nonfermenter bacteria infection cases in our hospital during July 2009 and June 2014 were analyzed retrospectively. Conventional method was used for the cultivation and identification of the bateria. K-B method was used to detect the resistance rate. Drug susceptibility results were analyzed according to CLSI 2013 standard. The data were analyzed using WHONET 5. 6 software. Results A total of 211 strains of nonfermenter bacteria were detected,among which Pseudomonas aeruginosa was the most common（ 42. 2%）,followed by Acinetobacter baumannii（ 28. 9%） and Stenotrophomonas maltophilia（ 20. 4%）. Four kinds of Nonfermenter bacteria were differently resistant to commonly used antibiotics; some were even multi-drug resistant. Conclusion Nonfermenter bacteria are common pathogens causing pulmonary infection in lung cancer patients,which are highly resistant and difficult to control. Drug resistance monitoring should be strengthened in order to provide guidance for rational use of drugs and prevention of secondary infections.