肺癌患者呼吸道非发酵菌继发感染分析

目的了解肺癌患者医院内获得性非发酵菌感染的细菌学特点和耐药谱,总结治疗经验,预防与控制医院感染。方法对109例确诊为肺癌患者在住院治疗过程中发生医院内获得性呼吸道非发酵菌感染的病原菌构成、耐药性以及疾病预后进行回顾性分析。结果医院内获得性呼吸道非发酵菌感染多发于肺癌患者;主要菌种铜绿假单胞菌55株占49.5%,鲍氏不动杆菌23株占20.7%,嗜麦芽寡养单胞菌8株占7.2%;铜绿假单胞菌对亚胺培南100.0%敏感,对复方新诺明100.0%耐药,对高浓度的替卡西林、哌拉西林及其复合制剂敏感率较高;鲍氏不动杆菌对抗菌药物的耐药率高于铜绿假单胞菌;嗜麦芽寡养单胞菌对大多数抗菌药物耐药,>50.0%对亚胺培南耐药率达100.0%,应引起临床足够的重视。结论非发酵菌医院内获得性感染耐药率高,治疗困难,预后较差,多重感染后死亡率高。

Nonfermenters Bacteria Infection in Lung Cancer Patients

OBJECTIVE To investigate the bacteriologic feature and the spectrum of drug resistance in lung cancer patients who got nosocomial nonfermenters bacteria infection,and to conclude the experience and how to prevent and control the nosocomial infection.METHODS A rectrospective analysis of the composition of the pathogens,the feature of drug resistance and the prognosis of 109 lung cancer inpatients with nosocomial infection was made.RESULTS Nosocomial nonfermenters bacteria infections were most happened in hospital lung cancer patients.Main strains included Pseudomonas aeruginosa 55(49.5%),Acinetobacter baumannii 23(20.7%),and Stenotrophomonas maltophilia 8(7.2%).The sensitive rate of P.aeruginosa to imipenem was 100%,but to Cotrimoxazole,the resistant rate was 100%.The sensitive rate was relatively high to ticarcillin,piperacillin and their compounds.The antimicrobial resistance rate of A.baumannii was higher than P.aeruginosa.Stenotrophomonas were resistant to most antibiotics,and the resistance rate to imipenem was 100.0%.CONCLUSIONS The resistance rate of nosocomial nonfermenters bacteria infection is high.The treatment is difficult and the prognosis is bad.The mortality of multiple infection is high.