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目的研究住院肺癌化疗患者医院感染病原学特征及相关危险因素,为有效防控提供科学依据。方法通过前瞻性研究方法,对某肿瘤医院内科住院肺癌化疗患者医院感染与感染病原菌特征进行观察,分析相关危险因素。结果该医院肿瘤内科共纳入肺癌化疗患者1 530例,发生医院感染56例,感染率3.66%。从56例感染患者送检标本中共分离病原菌74株,其中革兰阴性菌45株、革兰阳性菌16株和真菌13株。除真菌之外,所分离的病原菌均普遍耐药,尚未检出耐碳青霉烯类和耐万古霉素菌株。多因素分析显示,住院时间≥14 d、化疗周期≥2周和大量预防性使用抗菌药物等构成肺癌化疗患者医院感染的独立危险因素。结论肺癌化疗患者医院感染病原菌以革兰阴性菌为主,且耐药情况严重,缩短化疗周期和严格抗菌药物使用为主要防控措施。
Objective To study the etiological characteristics and risk factors of nosocomial infection in hospitalized patients with lung cancer and provide a scientific basis for effective prevention and control. Methods A prospective study was conducted to observe the characteristics of nosocomial infections and pathogenic bacteria in hospitalized lung cancer patients undergoing chemotherapy in a hospital, and to analyze the related risk factors. Results A total of 1 530 cases of lung cancer were included in the hospital’s oncology department. There were 56 nosocomial infections with the infection rate of 3.66%. A total of 74 pathogenic bacteria were isolated from 56 infected patients, including 45 Gram-negative bacteria, 16 Gram-positive bacteria and 13 fungi. In addition to fungi, the isolated pathogens are generally resistant to carbapenems and vancomycin-resistant strains have not been detected. Multivariate analysis showed that hospitalized patients with ≥14 days of hospitalization, chemotherapy cycles ≥2 weeks and a large amount of prophylactic use of antimicrobial agents constituted independent risk factors for nosocomial infections in patients with lung cancer. Conclusions The main pathogens causing nosocomial infection in patients with lung cancer are Gram-negative bacteria, and the drug resistance is serious, the cycles of chemotherapy and the strict antimicrobial use are the main prevention and control measures.