發(fā)布時間：2018-04-03 10:57

  本文選題：流感嗜血桿菌　切入點：肺癌　出處：《中國藥房》2017年17期

【摘要】：目的:探討肺癌合并肺部流感嗜血桿菌(Hi)感染的臨床病因、血清分型及耐藥情況,為預(yù)防感染和合理用藥提供參考。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臨床資料,分析肺部Hi感染的臨床病因。采用玻片凝集法進行Hi血清分型試驗,頭孢硝噻吩紙片法檢測其產(chǎn)β-內(nèi)酰胺酶情況,紙片擴散法進行藥敏試驗,并采用WHONET 5.6軟件處理藥敏試驗結(jié)果。結(jié)果:年齡、臨床分期、侵入性操作、手術(shù)、放化療、住院時間、使用廣譜抗菌藥物或激素等11種因素與肺癌患者發(fā)生肺部Hi感染密切相關(guān)(P0.05或P0.01)。8 025份標本中,共檢出Hi 104株,檢出率為1.30%。其血清分型以非分型為主,占44.23%;可分型菌株以b型居多(22.12%),其次為f型(17.31%)和a型(11.54%)。104株Hi中,檢出產(chǎn)β-內(nèi)酰胺酶菌株56株,產(chǎn)酶率為53.85%。104株Hi對氨芐西林、阿莫西林、復(fù)方磺胺甲VA唑和氯霉素的耐藥率均超過35%,對β-內(nèi)酰胺酶抑制劑、頭孢菌素類、碳青霉烯類和阿奇霉素等其他抗菌藥物的耐藥率均低于20%;產(chǎn)β-內(nèi)酰胺酶菌株對氨芐西林、阿莫西林、復(fù)方磺胺甲VA唑和氯霉素的耐藥率顯著高于非產(chǎn)酶菌株,差異均有統(tǒng)計學(xué)意義(P0.01);而產(chǎn)酶和非產(chǎn)酶菌株對其他抗菌藥物的耐藥率比較,差異均無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:肺癌患者發(fā)生肺部Hi感染的臨床病因十分復(fù)雜。我院檢出的Hi以非分型為主,且產(chǎn)酶情況不容樂觀,但對多數(shù)抗菌藥物耐藥率較低。臨床治療可首選β-內(nèi)酰胺酶抑制劑、頭孢菌素類、碳青霉烯類和阿奇霉素等抗菌藥物。
[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負涓，

本文編號：1704898