中国冶金工业医学杂志

肺癌晚期合并医院感染临床及耐药特征分析

作者：王子红陈文彰*

关键词：肺癌医院感染耐药特征

分类号：R 7342

出版年,卷(期):页码：2016,33(3):257-259

摘要：

目的分析肺癌晚期患者院内感染的病原菌分布及耐药特征，总结最佳治疗方案以控制感染。方法收集我科2012—2014年住院肺癌晚期院内感染患者63例，对其病原菌分布及耐药特点进行总结分析。结果63例患者共检出病原菌81株：G-杆菌61株占第一位,G+菌13株，真菌7株。呼吸道感染是最常见的感染部位。大肠埃希菌在泌尿系统感染中占绝对优势。大部分革兰氏阴性杆菌对头孢二代、三代抗生素、青霉素类、喹诺酮类耐药率占50%～80%，鲍曼不动杆菌对头孢类、青霉素类广泛耐药，耐药率80%～100%,其中有2株鲍曼不动杆菌对亚胺培南,有1株对美罗培南耐药。革兰氏阳性球菌对青霉素、红霉素、氯霉素、喹诺酮类等抗生素耐药率占75%～100%，对万古霉素、利奈唑胺无耐药菌株。结论肺癌晚期患者院内感染的病原体以G-杆菌为主，主要感染部位是呼吸道感染。大部分G-菌、G+菌耐药严重,尤其鲍曼不动杆菌耐药最严重。

关键词：肺癌;医院感染;耐药特征

ObjectiveTo investigate the etiology and drug resistance of nosocomial infection in patient with terminal lung cancer,summarize the best therapeutic schedule and control infectionMethodsA retrospective analysis was conducted of 63 patients who were treated in our department from January 2012 to December 2014,to summarize its pathogenic bacteria distribution and characteristics of drug resistanceResults82 strains pathogenic bacteria were detected in 63 patients,including 61 strains of gram negative bacteria,13 strains of gram positive bacteria and 7 strains of fungusRespiratory tract was the most common infection siteEcoli accounted was the main cause of the urinary infectionThe most of gram\|negative bacilli were resistant to second generation cephalosporin,three generations of antibiotics,penicillin,quinolone,and the drug resistance rate was 50~80%Acinetobacter baumannii strains were resistant to Cephalosporins and Penicillins,the drug resistance rate was about 80% to 100%,including 2 strains resistant to imipenem and 1 strain resistant to meropenemFor penicillin,Erythromycin,chloramphenicol and quinolone,the drug resistance rate of Gram\|positive cocci was 75%~100%There were no strain detected resistant to vancomycin and linezolidConclusionG- bacillus was the main pathogens of nosocomial infection in patients with lung cancer and the main infection site was respiratory tractThe drug resistance of most of the G-bacteria and G+ bacteria is serious,especially acinetobacter baumanniiKey Words:Lung cancer;Nosocomial infection;Resistance characteristics

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参考文献：

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