肺癌合并肺部流感嗜血杆菌感染的临床病因、血清分型及耐药性分析

发布时间：2018-04-03 10:57

  本文选题：流感嗜血杆菌　切入点：肺癌　出处：《中国药房》2017年17期

【摘要】：目的:探讨肺癌合并肺部流感嗜血杆菌(Hi)感染的临床病因、血清分型及耐药情况,为预防感染和合理用药提供参考。方法:收集我院2009年1月-2016年6月8 025例肺癌合并肺部感染住院患者的临床资料,分析肺部Hi感染的临床病因。采用玻片凝集法进行Hi血清分型试验,头孢硝噻吩纸片法检测其产β-内酰胺酶情况,纸片扩散法进行药敏试验,并采用WHONET 5.6软件处理药敏试验结果。结果:年龄、临床分期、侵入性操作、手术、放化疗、住院时间、使用广谱抗菌药物或激素等11种因素与肺癌患者发生肺部Hi感染密切相关(P0.05或P0.01)。8 025份标本中,共检出Hi 104株,检出率为1.30%。其血清分型以非分型为主,占44.23%;可分型菌株以b型居多(22.12%),其次为f型(17.31%)和a型(11.54%)。104株Hi中,检出产β-内酰胺酶菌株56株,产酶率为53.85%。104株Hi对氨苄西林、阿莫西林、复方磺胺甲VA唑和氯霉素的耐药率均超过35%,对β-内酰胺酶抑制剂、头孢菌素类、碳青霉烯类和阿奇霉素等其他抗菌药物的耐药率均低于20%;产β-内酰胺酶菌株对氨苄西林、阿莫西林、复方磺胺甲VA唑和氯霉素的耐药率显著高于非产酶菌株,差异均有统计学意义(P0.01);而产酶和非产酶菌株对其他抗菌药物的耐药率比较,差异均无统计学意义(P0.05)。结论:肺癌患者发生肺部Hi感染的临床病因十分复杂。我院检出的Hi以非分型为主,且产酶情况不容乐观,但对多数抗菌药物耐药率较低。临床治疗可首选β-内酰胺酶抑制剂、头孢菌素类、碳青霉烯类和阿奇霉素等抗菌药物。
[Abstract]:Objective: to investigate the clinical etiology, serological classification and drug resistance of lung cancer complicated with Hi-infection of Haemophilus influenzae, so as to provide reference for prevention of infection and rational use of drugs.Methods: clinical data of 8 025 patients with lung cancer complicated with pulmonary infection from January 2009 to June 2016 in our hospital were collected and the clinical etiology of pulmonary Hi infection was analyzed.Hi serum typing test was carried out by slide agglutination method, 尾 -lactamase production was detected by ceftathiophene disk method, drug sensitivity test was carried out by disk diffusion method, and drug sensitivity test results were processed by WHONET 5.6 software.Results: eleven factors, such as age, clinical stage, invasive operation, operation, radiotherapy and chemotherapy, hospitalization time, use of broad-spectrum antibiotics or hormones, were closely related to lung Hi infection in lung cancer patients (P0.05 or P0.010.8025). A total of 104 strains of Hi were detected.The detection rate was 1.30%.鍏惰��娓呭垎鍨嬩互闈炲垎鍨嬩负涓，

本文编号：1704898