老年肺癌患者术后发生院内肺部感染的病原菌分布及多重耐药性分析

目的分析老年肺癌患者术后发生院内肺部感染的病原菌分布特点及耐药性情况,为临床诊治提供一定参考依据。方法回顾性分析2016年8月—2019年8月收治的496例老年肺癌手术患者的临床资料,统计术后发生院内肺部感染的情况,总结肺部感染痰培养的细菌分离株及多重耐药性情况。结果496例老年肺癌患者术后发生院内肺部感染者117例(23.6%);共分离出162株病原菌,以革兰阴性菌(103株,63.58%)为主,其次为革兰阳性菌(38株,23.46%)和真菌(21株,12.96%)。药物敏感(药敏)试验结果显示革兰阴性菌、革兰阳性菌及真菌对常用抗菌药物的耐药率均较高。结论老年肺癌患者术后院内肺部感染发生率较高,最常见的病原菌是革兰阴性菌,且细菌耐药严重,甚至出现较多的多重耐药菌,临床上要加强病原菌的培养和药敏试验,合理选择抗菌药物。

Distribution of pathogenic bacteria and multi-drug resistance in postoperative nosocomial lung infection in senile patients with lung cancer

Objective To analyze the distribution characteristics and drug resistance of pathogenic bacteria in postoperative nosocomial lung infection in senile patients with lung cancer,and to provide certain reference for clinical diagnosis and treatment.Methods Clinical data of 496 senile patients with lung cancer who underwent a surgery from August 2016 to August 2019 were retrospectively analyzed.The incidence of pulmonary infection after surgery was statistically analyzed,and bacterial isolates and multidrug resistance in sputum culture of pulmonary infection were summarized.Results Among 496 senile patients with lung cancer,117 cases(23.6%)had postoperative nosocomial lung infection.A total of 162 pathogenic bacteria strains were isolated,mainly gramnegative bacteria(103 strains,63.58%),followed by gram-positive bacteria(38 strains,23.46%)and fungi(21 strains,12.96%).The drug sensitivity results showed that gram-negative bacteria,gram-positive bacteria and fungi were highly resistant to common antimicrobial agents.Conclusions The incidence of postoperative nosocomial lung infection is higher in senile patients with lung cancer.The most common pathogen is gram-negative bacteria,and bacterial resistance is serious,and even multiple drug resistant bacteria are frequently observed.The cultivation of pathogens and drug sensitivity test should be strengthened in clinical practice,and reasonable selection of antimicrobial agents is recommended.