肺癌患者医院感染之菌谱及耐药性分析

Pathogen Spectrum and Drug Resistance of Nosocomial Infection in Inpatients with Lung Cancer

目的 探讨肺癌患者医院感染病原菌的分布及其耐药状况。方法 回顾分析肺癌患者医院感染病例 ,采用 WHONET- 5软件进行统计处理。结果 感染菌检出率 :革兰阴性杆菌为 5 4 .8% ,以铜绿假单胞菌为主 ;革兰阳性球菌为 19.0 % ,以金黄色葡萄球菌为主 ;真菌为 2 6 .2 % ,以白色假丝酵母菌为主 ;药敏试验结果提示 :G-杆菌对亚胺培南高度敏感 ,对一代、二代头孢菌素、氨苄西林、哌拉西林等有较高耐药性 ;G+球菌对万古霉素高度敏感 ,对苯唑西林、青霉素、红霉素等的耐药率很高 ;真菌对唑类抗菌药呈明显耐药。结论 由于产超广谱 β-内酰胺酶菌 (ESBL s)和耐甲氧西林葡萄球菌 (MRS)检出率很高 ,临床用药应根据药敏试验结果选择抗生素 ,同时应加强抗生素的合理使用 ,控制细菌的耐药性。

OBJECTIVE To study the distribution of the pathogens causing nosocomial infection and drug resistance about inpatients with lung cancer. METHODS Four hundred and forty-two lung cancer cases with hospital acquired infection were analyzed by using the software of WHONET-5. RESULTS Of all the pathogenic species,the most prevalent species were Gram-negative bacteria with average positive detection of 54.8%. The second were fungi(26.2%). The third were Gram-positive bacteria(19.0%). The results of drug sensitivity tests showed that all of strains had higher resistance rate. The rate of extended-spectrum β-lactamases(ESBLs) was 40.5%,and meticillin-resistant Staphylococcus (MRS) was 78.1%. CONCLUSIONS The resistance of bacteria to the commonly used antibiotics is produced in various degrees. During clinical therapy with antibiotics,we should select antibiotics according to the results of drug sensitivity tests and consider the spectrum of pathogenic species as well as the changes in the resistance trends of isolates. In order to reduce the production of drug-resistance,the appropriate use of antibiotics must be strengthened.