【摘要】：目的研究肺癌患者肺膿腫感染病原菌分布、耐藥性以及預防,以降低感染發(fā)生。方法對2012年5月-2015年5月醫(yī)院治療的308例肺癌患者臨床資料進行回顧性分析,并對45例感染肺膿腫的患者進行痰液病原菌培養(yǎng)以及藥敏試驗,對病原菌分布特點以及耐藥性進行分析,提出預防治療措施。結(jié)果肺癌合并肺膿腫患者45例,感染率為14.61%;檢出病原菌分別為革蘭陰性菌、革蘭陽性菌及真菌,分別占53.66%、34.15%、12.19%,檢出以金黃色葡萄球菌、銅綠假單胞菌、肺炎克雷伯菌為主,分別占19.51%、23.17%、13.41%;革蘭陽性菌對阿米卡星、頭孢哌酮/舒巴坦、亞胺培南/西司他丁、萬古霉素的耐藥性較低;銅綠假單胞菌對阿米卡星、頭孢哌酮/舒巴坦、妥布霉素、亞胺培南/西司他丁的耐藥性較低;大腸埃希菌對亞胺培南以及亞胺培南/西司他丁具有較低的耐藥性;肺炎克雷伯菌對亞胺培南/西司他丁以及米諾環(huán)素的耐藥率較低。結(jié)論肺癌患者肺膿腫的感染率相對較高,應及時對患者痰液進行培養(yǎng)鑒別以及藥敏試驗,根據(jù)試驗結(jié)果合理的選用抗菌藥物,提高治療效果。
[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.
【作者單位】： 蘇州大學附屬常熟醫(yī)院呼吸內(nèi)科;
【基金】：國家自然科學基金資助項目(81060249)
【分類號】：R446.5

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