摘要
目的:探究早期肺癌伴有肺部感染患者痰标本中主要病原菌的构成及其对抗菌药物的耐药性,为临床合理抗感染治疗提供参考。方法:选取2016年4月—2020年6月间医院收治的早期肺癌伴肺部感染患者120例病历资料;统计其患者下呼吸道痰标本中病原菌的培养、分离及药敏试验结果;分析其痰标本中病原菌的构成情况及主要病原菌对各类抗菌药物的耐药特点。结果:120例患者痰标本中,分离出病原菌156株,其中以革兰阴性菌为主(56.41%),其次为革兰阳性菌(27.56%)和真菌(16.03%);主要革兰阳性菌中,金黄色葡萄球菌对青霉素的耐药率较高,粪肠球菌对克林霉素的耐药率较高,凝固酶阴性葡萄球菌对青霉素、克林霉素、庆大霉素的耐药率较高,三者对万古霉素的耐药率均较低;而主要革兰阴性菌中,铜绿假单胞菌对氨苄西林、头孢曲松、头孢唑林的耐药率较高,肺炎克雷伯菌、大肠埃希菌对氨苄西林的耐药率较高,三者对亚胺培南的耐药率均较低;主要真菌中,白假丝酵母对各抗真菌药物的耐药率均较低。结论:早期肺癌伴肺部感染疾病患者感染病原菌以革兰阴性菌为主,其耐药现象较为严重,且具有多重耐药性;综合药敏试验结果发现可考虑采用万古霉素或亚胺培南治疗,但临床实际用药仍需结合患者个体情况决定,并加强病原学检查及其耐药监测,以保证抗菌药物的合理使用。
Objective: To explore the composition of pathogenic bacteria and resistance to antimicrobial agents in sputum of patients suffering from early lung cancer with pulmonary infection, and to provide scientific guidance for reasonable clinical anti-infection treatment. Methods: The medical records of 120 patients with early lung cancer and pulmonary infection admitted to the hospital from April 2016 to June 2020 were selected. The culture, isolation and drug sensitivity test results of pathogenic bacteria in sputum specimen of the lower respiratory tract of the patients were counted. The composition of pathogenic bacteria in sputum of specimen and the resistance characteristics of main pathogenic bacteria to various antibacterial drugs were analyzed. Results: In the sputum specimens of 120 patients, 156 strains of pathogenic bacteria were isolated, in which Gram-negative bacteria(56.41%) were the dominant bacteria, followed by Gram-positive bacteria(27.56%) and Fungi(16.03%). Among the main Gram-positive bacteria, Staphylococcus aureus had higher drug resistance rate to penicillin, Enterococcus faecalis had higher drug resistance rate to clindamycin, Coagulase-negative Staphylococcus had higher drug resistance rate to penicillin, clindamycin and gentamicin,all of which had lower drug resistance rate to vancomycin. Among the main Gram-negative bacteria, the drug resistance rate of Pseudomonas aeruginosa to ampicillin, ceftriaxone and cefazolin was higher, that of Klebsiella pneumoniae and Escherichia coli to ampicillin was higher, and that of imipenem was lower. Candida albicans has low resistance rate to antifungal drugs among main fungi. Conclusion: The gram-negative bacteria were the main pathogenic bacteria in patients with early lung cancer and pulmonary infection, and the drug resistance was serious and had multiple drug resistance. The results of the comprehensive drug sensitivity test showed that vancomycin or imipenem could be considered to be good for treatment, but the actual clinical medication should stil
作者
李艳艳
王洪科
谷见法
邢国臣
易善永
LI Yan-yan;WANG Hong-ke;GU Jian-fa;XING Guo-chen;YI Shan-yong(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China)
出处
《抗感染药学》
2021年第3期343-346,共4页
Anti-infection Pharmacy
关键词
早期肺癌
肺部感染
痰标本
病原菌构成
合理用药
early lung cancer
pulmonary infection
sputum specimens
composition of pathogenic bacteria
the rational use of drugs
