论文部分内容阅读
目的分析肺癌住院患者医院感染病原菌类型、分布及耐药性情况,为及时有效的抗感染治疗提供科学依据。方法选取本院2012-2014年间发生医院的肺癌住院患者为研究对象,收集临床标本进行病原菌的分离培养,API鉴定系统对病原菌进行菌种鉴定,采用纸片扩散法进行药敏实验,并对数据进行统计分析。结果 189例发生医院感染的肺癌住院患者中呼吸道感染120例(占63.49%),泌尿道感染35例(占18.52%)。共分离206株病原菌,其中革兰阴性菌128株(占62.14%),革兰阳性菌65株(占31.55%),真菌13株(占6.31%)。革兰阴性菌中铜绿假单胞菌67株,肺炎克雷伯菌30株,鲍曼不动杆菌17株,大肠埃希菌14株;革兰阳性菌中金黄色葡萄球菌35株;白色假丝酵母菌和类酵母样菌,分别为8株和5株。革兰阴性病原菌对青霉素G、左氧氟沙星、阿米卡星、哌拉西林、环丙沙星、头孢他啶、氨曲南和头孢曲松等的耐药率分别为72.66%、61.72%、42.97%、30.47%、25.00%、25.00%、14.06%和7.81%。革兰阳性菌对青霉素G、左氧氟沙星、环丙沙星、阿奇霉素、阿米卡星、头孢呋辛、头孢他啶和头孢噻肟等的耐药率分别为76.92%、64.62%、52.31%、46.15%、43.08%、30.77%、20.00%和10.77%。真菌对氟康唑、氟胞嘧啶、伊曲康唑和伏立康唑等的耐药率分别为76.92%、53.85%、46.15%和23.08%。结论肺癌住院患者医院感染较多发生在呼吸道,病原菌以革兰阴性菌和铜绿假单胞菌最多,且对大部分常用抗菌药物的耐药率较高。及时监测患者感染病原菌类型及耐药情况可为肺癌患者的临床治疗提供科学指导。
Objective To analyze the types, distribution and drug resistance of nosocomial infection in hospitalized patients with lung cancer and provide a scientific basis for timely and effective anti-infection treatment. Methods The hospitalized patients with lung cancer from 2012 to 2014 in our hospital were selected as the research objects. The clinical specimens were collected for the isolation and culture of pathogens. The API identification system was used to identify the pathogenic bacteria. Drug susceptibility testing was conducted by disk diffusion method. conduct statistical analysis. Results Of the 189 hospitalized patients with nosocomial infections, 120 were respiratory tract infections (63.49%) and 35 were urinary tract infections (18.52%). A total of 206 pathogens were isolated, of which, 128 strains were Gram-negative bacteria (62.14%), 65 strains were Gram-positive bacteria (31.55%) and 13 were fungi (6.31%). Gram-negative bacteria Pseudomonas aeruginosa 67, Klebsiella pneumoniae 30, Acinetobacter baumannii 17, Escherichia coli 14; Gram-positive bacteria 35 Staphylococcus aureus; white leave Candida and yeast-like bacteria, respectively, 8 and 5 strains. The resistance rates of Gram-negative pathogens to penicillin G, levofloxacin, amikacin, piperacillin, ciprofloxacin, ceftazidime, aztreonam and ceftriaxone were 72.66%, 61.72%, 42.97% and 30.47 %, 25.00%, 25.00%, 14.06% and 7.81%. The resistance rates of Gram-positive bacteria to penicillin G, levofloxacin, ciprofloxacin, azithromycin, amikacin, cefuroxime, ceftazidime and cefotaxime were 76.92%, 64.62%, 52.31%, 46.15% 43.08%, 30.77%, 20.00% and 10.77%. The resistance rates of fungi to fluconazole, flucytosine, itraconazole and voriconazole were 76.92%, 53.85%, 46.15% and 23.08%, respectively. Conclusions Nosocomial nosocomial infections in lung cancer occur more frequently in the respiratory tract. Most of the pathogenic bacteria are Gram-negative bacteria and Pseudomonas aeruginosa, and most of the commonly used antibacterials have a high resistance rate. Timely monitoring of patient-acquired pathogen types and drug resistance can provide scientific guidance for the clinical treatment of patients with lung cancer.