恶性肿瘤并发下呼吸道感染患者呼吸道标本中非发酵菌的分布及其耐药性分析

Analysis of Distribution and Drug Resistance of Non-Fermenting Bacteria in Respiratory Specimens of Patients with Malignancy Complicated with LRTI

目的:分析恶性肿瘤并发下呼吸道感染患者呼吸道标本中非发酵菌的分布及其耐药特点。方法:选取2020年1月—12月永煤集团总医院收治的102例恶性肿瘤并发下呼吸道感染患者作为研究对象,分析患者呼吸道标本中非发酵菌的分布及其耐药情况。结果:102例并发下呼吸道感染患者的呼吸道标本中共分离出病原菌140株,其中非发酵菌有78株,分别为铜绿假单胞菌(35株)、鲍曼不动杆菌(26株)、嗜麦芽窄食单胞菌(8株)、洋葱伯克霍尔德菌(6株)和脑膜炎败血黄杆菌(3株);药敏结果显示,铜绿假单胞菌对头孢哌酮-舒巴坦钠、哌拉西林-他唑巴坦钠、哌拉西林、头孢他啶、头孢吡肟、氨曲南、环丙沙星、左氧氟沙星、阿米卡星、妥布霉素的耐药率均较低(<30.00%),嗜麦芽窄食单胞菌对哌拉西林-他唑巴坦钠、米诺环素的耐药率较低(<15.00%),鲍曼不动杆菌仅对头孢哌酮-舒巴坦钠的耐药率相对较低(30.77%),洋葱伯克霍尔德菌和脑膜炎败血黄杆菌对所试抗菌药物的耐药率均大于30.00%。结论:恶性肿瘤患者并发下呼吸道感染的主要非发酵致病菌为铜绿假单胞菌和鲍曼不动杆菌,但嗜麦芽窄食单胞菌、洋葱伯克霍尔德菌和脑膜炎败血黄杆菌也有检出,5种非发酵菌的耐药特点差异较大,临床应根据微生物培养结果和耐药情况合理选择抗菌药物,以提高抗感染治疗效果。

Objective:To analyze the distribution and drug resistance characteristics of non-fermenting bacteria in respiratory specimens from patients with malignancy complicated with lower respiratory tract infection(LRTI).Methods:A total of 102 patients with malignancy complicated with LRTI who were admitted to General Hospital of Yongmei Group from January to December 2020 were selected as the subjects,to analyze the distribution and drug resistance of non-fermenting bacteria in the respiratory specimens of the patients.Results:A total of 140 strains of pathogenic bacteria were isolated from the respiratory specimens of 102 patients with LRTI,including 78 strains of non-fermenting bacteria of Pseudomonas aeruginosa(35 strains),Acinetobacter baumannii(26 strains),Stenotrophomonas maltophilia(8 strains),Burkholderia cepacia(6 strains)and Flavobacterium meningosepticum(3 strains).The drug susceptibility test results showed that the drug resistance rate of Pseudomonas aeruginosa to cefoperazone-sulbactam sodium,piperacillintazobactam sodium,piperacillin,ceftazidime,cefepime,aztreonam,ciprofloxacin,levofloxacin,amikacin and tobramycin was low(less than 30.00%),the drug resistance rate of Stenotrophomonas maltophilia to piperacillin-tazobactam sodium and minocycline was low(less than 15.00%),while the drug resistance rate of Acinetobacter baumannii to cefoperazonesulbactam sodium was relatively low(30.77%),and the drug resistance rates of both Burkholderia cepacia and Flavobacterium meningosepticum to the tested antibacterials were more than 30.00%.Conclusion:Pseudomonas aeruginosa and Acinetobacter baumannii are the main non-fermenting pathogenic bacteria of patients with malignancy complicated with LRTI,but Stenotrophomonas maltophilia,Burkholderia cepacia and Flavobacterium meningosepticum are also detected.The drug resistance characteristics of the 5 non-fermenting bacteria are quite different.Clinically,the antibacterials should be reasonably chosen according to the results of microbial culture and drug resistance,so as to improve the effect of anti-infective therapy.