肺癌合并肺部感染的病原学和耐药性分析

目的了解铜陵地区肺癌合并肺部感染的病原学特征和耐药情况,为抗菌药物使用提供依据。方法收集3年所有肺癌合并肺部感染患者痰标本进行病原菌培养,采用K-B法进行药敏试验。结果共分离出各类致病菌142株,其中革兰阳性球菌占14.1%,革兰阴性杆菌占78.2%,真菌占7.8%。未检出对万古霉素耐药的葡萄球菌。肺炎克雷伯杆菌和大肠埃希菌对β-内酰胺酶抑制剂药物耐药率较低,对亚胺培南无耐药。铜绿假单胞菌对亚胺培南耐药率为25.0%,鲍曼不动杆菌对大多数抗菌药物耐药率在50%以上。结论肺癌合并肺部感染的致病菌以革兰阴性杆菌为主,且耐药现象严重。

Analysis on the etiology and resistance of lung cancer with pulmonary infection

Objective To investigate the etiology and resistance of lung cancer with pulmonary infection and guide rational use of antibiotics. Methods Sputum specimens were collected from lung cancer patients with pulmonary infections. Antimicrobial susceptibility test was detected by Kirby-Bauer method. Results A total of 142 strains were isolated, including 20 （ 14. 1% ） strains of gram positive bacteria, 111 （78.2%） strains of gram negative bacteria and 11 （7. 8 % ） strains of fungus. No vancomycin or teicoplanin resistant strains were found in Staphylococcus. Klebsiella pneumoniae and Eschericbea coli were relatively sensitive to cefoperazone-sulbactam and piperacillin-tazobactam. No imipenem resistant isolate was found. The resistant percentage of P. aeruginosa to cefotaxime, ceftriaxone and imipenem were. 100% , 100% and 25%. More than 50% of A. baumannii strains were resistant to all the antibiotics except cefoperazone- sulbactam. Conclusions Most clinical isolates of lung cancer with pulmonary infection were gram negative bacilli. The resistance of com- mon pathogenic bacteria was serious, rational choice and application of antibiotics should be in accordance with the drug sensitive test