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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。
Objective To analyze the distribution and drug resistance characteristics of nosocomial infections in patients with advanced lung cancer and to summarize the best treatment to control the infection. Methods Sixty-three inpatients with nosocomial lung cancer in our department from 2012 to 2014 were collected, and the distribution of their pathogens and drug resistance were analyzed. Results A total of 81 pathogens were detected in 63 patients: 61 strains of G-bacteria accounted for the first place, 13 strains of G + bacteria and 7 strains of fungi. Respiratory infections are the most common site of infection. Escherichia coli in the urinary tract infection accounted for the absolute advantage. Gram-negative bacilli accounted for 50% -80% of the second generation cephalosporin, third generation antibiotics, penicillins and quinolones, and Acinetobacter baumannii was widely resistant to cephalosporins and penicillins with a resistance rate of 80% ~ 100%, of which 2 strains of Acinetobacter baumannii to imipenem and 1 to meropenem were resistant. Gram-positive cocci penicillin, erythromycin, chloramphenicol, quinolones and other antibiotics resistance rate of 75% to 100%, vancomycin, linezolid no drug-resistant strains. Conclusions The pathogen of nosocomial infection in patients with advanced lung cancer is G - Bacillus. The main infection site is respiratory tract infection. Most G ~ - bacteria, G ~ + bacteria resistant to serious, in particular Acinetobacter baumannii most resistant.