肺癌患者呼吸道病原菌的分布与药敏分析

Analysis of distribution and drug sensitivity of respiratory pathogens in patients with lung cancer

目的分析本院肺癌患者呼吸道病原菌的分布与药敏情况,为临床抗感染治疗提供依据。方法采用EXCEL、SPSS 17.0及WHONET 5.6软件对2016年3月~2017年5月期间在我院住院治疗的99例肺癌患者痰培养分离的病原菌及药敏结果进行统计分析。结果肺部感染以60~69岁的老年肺癌患者居多,痰培养总共分离出病原菌138株,其中革兰阳性菌4株,占2.90%;革兰阴性菌96株,占69.56%,主要以肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌为主;真菌38株,占27.54%,以白色念珠菌为主。25例患者存在混合感染或双重感染的情况,其中混合感染9例,双重感染16例。鲍曼不动杆菌对常用抗菌药物都有耐药性,但对妥布霉素较敏感;铜绿假单胞菌耐药性高,对庆大霉素、妥布霉素、左旋氧氟沙星敏感;肺炎克雷伯菌耐药性最低,对头孢吡肟、亚胺培南、庆大霉素、妥布霉素敏感;白色念珠菌对抗真菌药物敏感。结论 60~69岁的老年肺癌患者易发生呼吸道感染,感染以肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和白色念珠菌为主,临床应培养医护人员的无菌操作意识,合理应用抗菌药物。

Objective To analyze the distribution and drug susceptibility of respiratory tract pathogens in lung cancer patients, and to provide evidences for clinical anti-infective treatment. Methods EXCEL, SPSS 17.0 and WHONET 5.6 software were used to statistically analyze the pathogens and drug susceptibility of sputum culture isolated from 99 cases with lung cancer patients who were hospitalized in our hospital from March 2016 to May 2017. Results Pulmonary infection was mainly distributed in 60to 69 years old patients with lung cancer. A total of 138 strains of pathogens were isolated from sputum culture, of which 4 were Gram-positive bacteria, accounting for 2.90%; 96 were Gram-negative bacteria, accounting for 69.56%, there were mainly Klebsiella pneumoniae, Acinetobacter baumannii and Pseu- domonas aeruginosa; There were 38 strains of fungi, accounting for 27.54%, with mainly Candida albicans. 25 patients had mixed infection or double infection, among whom mixed infection was in 9 cases, and double infection was in 16 cases. Acinetobacter baumannii was resistant to common antimicrobial drugs but was more sensitive to tobramycin; Pseudomonas aeruginosa was highly resistant, but was sensitive to gentamicin, tobramycin and levofloxacin; Klebsiella pneumoniae had the lowest drug resistance, and was sensitive to cefepime, imipenem, gentamicin, tobramycin; Candida albicans was sensitive to antifnngal agents. Conclusion 60-69 years old patients with lung cancer are prone to respiratory infections, and the infections are mainly Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Candida albicans. A sense of aseptic operation and rational use of antibiotics should be focused on in clinical training of health care workers.