摘要
目的探讨肺癌合并慢性阻塞性肺病(COPD)患者化疗后发生肺部感染的病原菌耐药情况。方法选取2019年4月至2022年4月间西安市北方医院接收的91例化疗后肺癌合并COPD患者,采集其痰液标本展开病原学检测,分析病原菌耐药情况。结果91例患者中,菌株共培养出147株,其中革兰阴性菌占73.5%(108/146),革兰阳性菌占9.5%(14/146),另外17.0%(25/146)为真菌。药敏试验发现,革兰阴性菌对大量抗菌药物耐药性较高,但对碳青霉烯类药物比较敏感。革兰阳性菌对青霉素、氨苄西林等均有较高耐药性,对利奈唑胺、替考拉宁、万古霉素则较为敏感。白假丝酵母菌、光滑假丝酵母菌对氟康唑、酮康唑均有较高耐药性,对5-氟尿嘧啶、两性霉素B则敏感性较高。结论肺癌合并COPD化疗后肺部感染致病菌以革兰阴性菌为主,其次为革兰阳性菌、真菌,且对多种常用抗菌药物耐药性较高,临床实际中应用合理选择抗菌药物。
Objective To analyze pathogenic bacteria and antimicrobial resistance in patients with lung cancer and chronic obstructive pulmonary disease(COPD)complicated with pulmonary infection after chemotherapy.Methods Ninety-one patients with lung cancer and COPD who developed pulmonary infection after undergoing chemotherapy at Xi'an North Hospital were selected from April 2019 to April 2022.The sputum samples were collected,and pathogenic detection was carried out to analyze the antimicrobial resistance in bacterial pathogens.Results A total of 146 strains were cultured from 91 patients,of which 73.5%(108/146)were gram-negative baclli,9.5%(14/146)were gram-positive cocci,and 17.0%(25/146)were fungi.The drug susceptibility test showed that gram-negative bacilli were highly resistant to multiple antibiotics but were susceptible to carbapenem antibiotics.gram-positive cocci were highly resistant to penicillin,ampicillin but were susceptible to linezolid,teicoplanin and vancomycin.Candida albicans and Candida glabrata are highly resistant to fluconazole and ketoconazole,but were sensitive to 5-fluorouracil and amphotericin B.Conclusion Gram-negative bacteria are the main pathogens for pulmonary infection after chemotherapy in patients with lung cancer combined with COPD,followed by Gram-negative bacteria and fungi,and they are highly resistant to a variety of commonly used antibiotics.Antimicrobial agents should be used reasonably in the clinical practice.
作者
李翠鸽
柳松勃
王萌
尹蓓蓓
LI Cui-ge;LIU Song-bo;WANG Meng;YIN Bei-bei(Department of geriatrics,Xi'an North Hospital,Xi'an 710043,China;Department of Respiratory Medicine,Xi'an North Hospital,Xi'an 710043,China)
出处
《中国肿瘤临床与康复》
2022年第11期1305-1308,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
肺肿瘤
慢性阻塞性肺疾病
药物治疗
肺部感染
病原菌
耐药情况
Lung neoplasms
Chronic obstructive pulmonary disease
Drug therapy
Pulmonary infection
Pathogenic bacteria
Resistance
