老年胃癌并发糖尿病患者术后感染的病原菌分布及耐药性分析

Analysis of pathogen distribution and drug resistance in elderly patients with gastric cancer complicated with diabetes after operation

[目的]研究老年胃癌并发糖尿病患者术后感染的病原菌分布及耐药性,以期为感染诊治提供参考。[方法]回顾性分析734例老年胃癌并发糖尿病患者的临床资料。分离培养采集到的患者标本细菌,采用GP法进行革兰阴性菌药敏试验,采用GN201法进行革兰阳性菌药敏试验。[结果]老年胃癌并发糖尿病患者术后感染136例(感染率18.52%),患者共分离培养病原菌158株,其中革兰阴性菌96株(60.76%)、革兰阳性菌58株(36.71%)、真菌4株(2.53%)。主要革兰阳性菌中,表皮葡萄球菌对青霉素、红霉素耐药率分别为100.00%、77.78%,金黄色葡萄球菌对青霉素、红霉素耐药率分别为91.67%、83.33%。主要革兰阴性菌中,大肠埃希菌对头孢他啶、左氧氟沙星耐药率分别为93.33%、80.00%,肺炎克雷伯菌对头孢哌酮、环丙沙星耐药率分别为76.92%、69.23%,铜绿假单胞菌对左氧氟沙星耐药率为80.00%。[结论]老年胃癌并发糖尿病患者术后感染率较高,病原菌分布主要为革兰阴性菌,且对头孢哌酮、头孢他啶、左氧氟沙星等的耐药率较高,值得临床上感染诊治时借鉴。

[Objective]To study the distribution and drug resistance of pathogenic bacteria in elderly patients with gastric cancer complicated with diabetes after operation,in order to provide reference for the diagnosis and treatment of infection.[Methods]The clinical data of 734elderly patients with gastric cancer complicated with diabetes were retrospectively analyzed.The bacteria collected from the patient samples were isolated and cultured,and the drug sensitivity test of Gram-negative bacteria was carried out by GP method,and the drug sensitivity test of Gram-positive bacteria was carried out by GN201method.[Results]The totals of 136cases of elderly patients with gastric cancer complicated with diabetes were infected after operation(infection rate 18.52%).A total of 158strains of pathogenic bacteria were isolated and cultured from the patients,including 96strains of Gram-negative bacteria(60.76%),58strains of Gram-positive bacteria(36.71%)and 4strains of fungi(2.53%).Among the major gram-positive bacteria,the drug resistance rates of Staphylococcus epidermidis to penicillin and erythromycin were 100.00%and 77.78%,respectively,and those of Staphylococcus aureus to penicillin and erythromycin were 91.67%and 83.33%,respectively.Among the major gram-negative bacteria,the drug resistance rates of Escherichia coli to cefetazidime and levofloxacin were 93.33%and 80.00%,respectively,the drug resistance rates of Klebsiella pneumoniae to cefoperazone and ciprofloxacin were 76.92%and 69.23%,respectively,and the drug resistance rates of Pseudomonas aeruginosa to levofloxacin were 80.00%.[Conclusion]The postoperative infection rate of elderly patients with gastric cancer complicated with diabetes is high,the distribution of pathogenic bacteria is mainly Gram-negative bacteria,and the drug resistance rate of cefoperazone,cefetazidime and levofloxacin is high,which is worthy of reference in clinical infection diagnosis and treatment.