呼吸科重症加强治疗病房肺癌病原菌分布及耐药性分析

目的了解近年来呼吸科重症加强治疗病房(RICU)肺癌患者院内下呼吸道感染病原菌分布及耐药情况。方法对2003年3月—2008年7月长海医院(RICU)366例住院肺癌患者下呼吸道感染痰细菌分离株及耐药监测情况进行回顾性分析。结果共分离细菌392株,病原菌革兰阴性占53.3%,以铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌为多见;革兰阳性菌占18.7%,主要是金黄色葡萄球菌;真菌占27.8%。致病菌对常用抗生素都不同程度地产生了耐药性,对青霉素、氨苄西林耐药率最高,对亚胺培南-西司他丁的耐药率最低,未发现对万古霉素耐药的金黄色葡萄球菌。结论RICU肺癌患者院内下呼吸道感染的主要病原菌为革兰阴性菌,细菌耐药性严重,并且具有多重耐药性。因RICU肺癌院内感染,患者预后相对较差,应早期采用有效的干预措施。

Pathogenic Bacteria of Nosocomial Infection and Their Drug Resistance in Patients with Lung Cancer in Respiratory Intensive Care Unit

Objective To investigate the pathogenic bacteria of nosocomial infection in patients with lung cancer in respiratory intensive care unit(RICU),as well as their drug resistance.Methods The results of pathogenic bacteria and drug resistance tests of 366 cases between March,2003 and June,2008 were retrospectively analyzed.Results A total of 392 strains of bacteria were isolated.Of the 392 strains,53.3% were Gram-negative,18.7% were Gram-positive,and 27.8% were fungi.The most common pathogens in the Gram-negative bacteria were pseudomonas aeruginosa,escherichia coli and klebsiella pneumoniae,and the most common Gram-positive pathogen was staphylococcus aureus.A11 the isolated pathogenic bacteria were resistant to the commonly used antibiotics at diferent levels.The pathogens were highly resistant to penicillin aud ampicillin,and sensitive to imipenem/cilastatin.All the staphylococci aureus were sensitive to vancomycin.Conclusion In RICU,most pathogens in the lower respiratory tracts in the patients with lung cancer are Gram-negative bacteria with a high resistance to the commonly used antibiotics.Early and effective treatment is needed considering their poor prognoses.