鼻咽癌患者感染病原菌分布及耐药性分析

发布时间：2018-04-10 21:31

  本文选题：鼻咽癌 + 治疗　； 参考：《中华医院感染学杂志》2017年23期

【摘要】：目的探究鼻咽癌患者感染病原菌分布及耐药性分析。方法选取于2013年10月-2016年10月医院收治的120例鼻咽癌合并医院感染患者,采集感染部位标本行病原菌培养及鉴定,分析比较鼻咽癌患者治疗方式、病原菌感染部位、病原菌种类、主要病原菌对抗菌药物耐药性以及耐药率。结果鼻咽癌患者以口腔感染居多,感染率为64.17%,其次分别是皮肤感染和呼吸系统感染,感染率分别为20.83%和10.00%;120例鼻咽癌患者感染部位标本中共分离出137株病原菌,其中真菌73株占53.28%,革兰阴性菌50株占36.50%,革兰阳性菌14株占10.22%;白假丝酵母对灰黄霉素耐药率最低,为19.57%,对伏立康唑耐药率最高,为50.00%;热带假丝酵母对灰黄霉素耐药率为11.76%,对伏立康唑耐药率为52.94%。铜绿假单胞菌、鲍氏不动杆菌以及肺炎克雷伯菌对阿米卡星耐药率均较低,对磺胺甲VA唑/甲氧苄啶耐药率高。结论采用同期放化疗治疗的鼻咽癌患者感染率最高,发生院内感染的鼻咽癌患者感染部位常见于口腔;根据药敏分析结果规范使用抗菌药物治疗,预防鼻咽癌患者发生院内感染或降低患者发生多重感染,提高预后。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogenic bacteria in nasopharyngeal carcinoma (NPC) patients.Methods 120 patients with nasopharyngeal carcinoma complicated with nosocomial infection were collected from October 2013 to October 2016.The types of pathogens, the resistance of main pathogens to antimicrobial agents and the rate of drug resistance.Results the majority of nasopharyngeal carcinoma patients were oral infection with infection rate of 64.17, followed by skin infection and respiratory infection. The infection rates were 20.83% and 10.00%, respectively. 137 strains of pathogenic bacteria were isolated from infected sites of 120 patients with nasopharyngeal carcinoma.Among them, 73 strains of fungi accounted for 53.28%, 50 strains of Gram-negative bacteria accounted for 36.50 and 14 strains of Gram-positive bacteria accounted for 10.22.The resistance rate of Candida albicans to Grysoflavin was the lowest, 19.57, and the rate of resistance to voriconazole was the highest.The resistance rate of Candida tropicalis to Grysoflavin was 11.76 and to voriconazole was 52.94.Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae showed lower resistance to amikacin and higher resistance to sulfamethazol / trimethoprim.Conclusion the infection rate of nasopharyngeal carcinoma patients treated with concurrent radiotherapy and chemotherapy is the highest, the infection site of nasopharyngeal carcinoma patients with nosocomial infection is common in the oral cavity, and the antimicrobial therapy is standardized according to the results of drug sensitivity analysis.Prevention of nosocomial infection or reduction of multiple infections in patients with nasopharyngeal carcinoma and improvement of prognosis.
【作者单位】： 河南南阳医专一附院耳鼻喉头颈外科;河南南阳医专一附院口腔科;河南南阳医专一附院肿瘤内科;河南南阳医专一附院呼吸内科;
【基金】：河南省卫生厅基金资助项目(20121315)
【分类号】：R739.63
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本文编号：1733000