肺癌患者放化疗后合并肺部感染的病原菌种类及耐药状况分析

目的：探讨肺癌患者放化疗后合并肺部感染的病原菌种类及耐药状况，以指导临床合理选用抗生素。方法：回顾性调查分析208例肺癌患者放化疗后合并肺部感染患者痰培养及药敏结果。结果：208例肺癌患者放化疗后合并肺部感染者，痰培养共检出菌株166株，以革兰阴性杆菌为主（57．8％），其次为革兰阳性球菌（10．2％）和真菌（31．9％）。最多的革兰阴性杆菌是肺炎克雷伯菌，其次为铜绿假单胞菌；革兰阳性球菌主要是葡萄球菌；真菌以白色假丝酵母菌为主。药敏试验显示，革兰阴性杆菌对亚胺培南、美罗培南最敏感；革兰阳性球菌对万古霉素最为敏感；真菌对5-氟胞嘧啶和两性霉素B较敏感。结论：革兰阴性杆菌是肺癌患者放化疗后合并肺部感染的主要病原菌，且细菌耐药性严重，真菌感染率较高，应当引起足够重视。

Analysis of pulmonary infection pathogens and drug resistance in lung cancer patients after radiotherapy and chemotherapy-

Abstract：Objective： To investigate the pulmonary infection pathogens and drug resistance in lung cancer patients after radiotherapy and chemotherapy in order to supervise the clinical rational use of antibiotics. Methods： Sputum culture detection and drug sensitivity testing results of 208 lung cancer patients combined with pulmonary infection after radiotherapy and chemotherapy were retrospectively investigated and analyzed. Results： Of the 208 lung cancer patients with pulmonary infection after radiotherapy and chemotherapy, 166 strains of bacterial strains had been detected, which were mainly gram-negative bacilli （57. 8 %/60）, followed by grampositive cocci （ 10. 2 %） and fungi（31.9%）. Most gram-nagative bacterial were klebsiella pneumoniae, followed by pseudo monas aeruginosa; gram-positive cocci was mainly staphylococci; the most common fungus was candida albicans. Susceptibility tests showed that gramnegative bacilli are most sensitive to imipen em and meropenem; gram-positive cocci was sensitive to vancomycin; and fungi was more sensitive to 5-fluorocytosine and amphotericin B. Conclusion： Gramnegative bacteria are the main pathogens in lung cancer patients combined with pulmonary infection after radiotherapy and chemotherapy. Because of its severe bacterial resistance, higher fungal infection, sufficient attention should be paid to it.