本文選題：鼻咽癌 + 治療��； 參考：《中華醫(yī)院感染學(xué)雜志》2017年23期

【摘要】：目的探究鼻咽癌患者感染病原菌分布及耐藥性分析。方法選取于2013年10月-2016年10月醫(yī)院收治的120例鼻咽癌合并醫(yī)院感染患者,采集感染部位標(biāo)本行病原菌培養(yǎng)及鑒定,分析比較鼻咽癌患者治療方式、病原菌感染部位、病原菌種類、主要病原菌對抗菌藥物耐藥性以及耐藥率。結(jié)果鼻咽癌患者以口腔感染居多,感染率為64.17%,其次分別是皮膚感染和呼吸系統(tǒng)感染,感染率分別為20.83%和10.00%;120例鼻咽癌患者感染部位標(biāo)本中共分離出137株病原菌,其中真菌73株占53.28%,革蘭陰性菌50株占36.50%,革蘭陽性菌14株占10.22%;白假絲酵母對灰黃霉素耐藥率最低,為19.57%,對伏立康唑耐藥率最高,為50.00%;熱帶假絲酵母對灰黃霉素耐藥率為11.76%,對伏立康唑耐藥率為52.94%。銅綠假單胞菌、鮑氏不動桿菌以及肺炎克雷伯菌對阿米卡星耐藥率均較低,對磺胺甲VA唑/甲氧芐啶耐藥率高。結(jié)論采用同期放化療治療的鼻咽癌患者感染率最高,發(fā)生院內(nèi)感染的鼻咽癌患者感染部位常見于口腔;根據(jù)藥敏分析結(jié)果規(guī)范使用抗菌藥物治療,預(yù)防鼻咽癌患者發(fā)生院內(nèi)感染或降低患者發(fā)生多重感染,提高預(yù)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.
【作者單位】： 河南南陽醫(yī)專一附院耳鼻喉頭頸外科;河南南陽醫(yī)專一附院口腔科;河南南陽醫(yī)專一附院腫瘤內(nèi)科;河南南陽醫(yī)專一附院呼吸內(nèi)科;
【基金】：河南省衛(wèi)生廳基金資助項目(20121315)
【分類號】：R739.63
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本文編號：1733000