肺癌患者合并肺脓肿感染的特点与防治研究
发布时间：2019-04-21 08:21
【摘要】：目的研究肺癌患者肺脓肿感染病原菌分布、耐药性以及预防,以降低感染发生。方法对2012年5月-2015年5月医院治疗的308例肺癌患者临床资料进行回顾性分析,并对45例感染肺脓肿的患者进行痰液病原菌培养以及药敏试验,对病原菌分布特点以及耐药性进行分析,提出预防治疗措施。结果肺癌合并肺脓肿患者45例,感染率为14.61%;检出病原菌分别为革兰阴性菌、革兰阳性菌及真菌,分别占53.66%、34.15%、12.19%,检出以金黄色葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌为主,分别占19.51%、23.17%、13.41%;革兰阳性菌对阿米卡星、头孢哌酮/舒巴坦、亚胺培南/西司他丁、万古霉素的耐药性较低;铜绿假单胞菌对阿米卡星、头孢哌酮/舒巴坦、妥布霉素、亚胺培南/西司他丁的耐药性较低;大肠埃希菌对亚胺培南以及亚胺培南/西司他丁具有较低的耐药性;肺炎克雷伯菌对亚胺培南/西司他丁以及米诺环素的耐药率较低。结论肺癌患者肺脓肿的感染率相对较高,应及时对患者痰液进行培养鉴别以及药敏试验,根据试验结果合理的选用抗菌药物,提高治疗效果。
[Abstract]:Objective to study the distribution, drug resistance and prevention of bacterial infection in lung abscess in patients with lung cancer in order to reduce the incidence of infection. Methods the clinical data of 308 patients with lung cancer treated in hospital from May 2012 to May 2015 were retrospectively analyzed, and the sputum pathogenic bacteria culture and drug sensitivity test were carried out in 45 patients with lung abscess. The distribution characteristics and drug resistance of pathogenic bacteria were analyzed, and the preventive and therapeutic measures were put forward. Results the infection rate was 14.61% in 45 patients with lung cancer complicated with lung abscess. Gram-negative bacteria, gram-positive bacteria and fungi accounted for 53.66%, 34.15% and 12.19% respectively. Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumoniae were the main pathogens, accounting for 19.51% respectively. 23.17%, 13.41%; Gram-positive bacteria were less resistant to amikacin, cefoperazone / sulbactam, imipenem / cilastatin and vancomycin. Pseudomonas aeruginosa had lower resistance to amikacin, cefoperazone / sulbactam, tobramycin, imipenem / cilastatin and Escherichia coli to imipenem and imipenem / cilastatin. Klebsiella pneumoniae was less resistant to imipenem / cilastatin and minocycline. Conclusion the infection rate of lung abscess in patients with lung cancer is relatively high. The sputum of the patients should be cultured and identified in time and the drug sensitivity test should be carried out. According to the results of the test, the antibiotics should be selected reasonably to improve the therapeutic effect.
【作者单位】： 苏州大学附属常熟医院呼吸内科;
【基金】：国家自然科学基金资助项目(81060249)
【分类号】：R446.5
[Abstract]:Objective to study the distribution, drug resistance and prevention of bacterial infection in lung abscess in patients with lung cancer in order to reduce the incidence of infection. Methods the clinical data of 308 patients with lung cancer treated in hospital from May 2012 to May 2015 were retrospectively analyzed, and the sputum pathogenic bacteria culture and drug sensitivity test were carried out in 45 patients with lung abscess. The distribution characteristics and drug resistance of pathogenic bacteria were analyzed, and the preventive and therapeutic measures were put forward. Results the infection rate was 14.61% in 45 patients with lung cancer complicated with lung abscess. Gram-negative bacteria, gram-positive bacteria and fungi accounted for 53.66%, 34.15% and 12.19% respectively. Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumoniae were the main pathogens, accounting for 19.51% respectively. 23.17%, 13.41%; Gram-positive bacteria were less resistant to amikacin, cefoperazone / sulbactam, imipenem / cilastatin and vancomycin. Pseudomonas aeruginosa had lower resistance to amikacin, cefoperazone / sulbactam, tobramycin, imipenem / cilastatin and Escherichia coli to imipenem and imipenem / cilastatin. Klebsiella pneumoniae was less resistant to imipenem / cilastatin and minocycline. Conclusion the infection rate of lung abscess in patients with lung cancer is relatively high. The sputum of the patients should be cultured and identified in time and the drug sensitivity test should be carried out. According to the results of the test, the antibiotics should be selected reasonably to improve the therapeutic effect.
【作者单位】： 苏州大学附属常熟医院呼吸内科;
【基金】：国家自然科学基金资助项目(81060249)
【分类号】：R446.5
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