肺癌患者院内感染微生物学特点及预后因素分析

目的:探讨肺癌患者院内感染的临床特征、微生物学特点以及预后因素。方法:回顾性分析2013年08月至2019年06月在我院肿瘤中心治疗的171例肺癌合并院内感染患者的临床资料，分析院内感染的发生率、微生物学特点、院内死亡率及其影响因素。结果:1 008例肺癌患者中，171例（17.0%）患者发生院内感染，呼吸道感染所占比例最高，为76.0%。分离的病原体主要包括革兰阴性菌、真菌和革兰阳性菌。白色假丝酵母菌是最主要的致病菌，占14.6%，其次是肺炎克雷伯菌（12.9%）、铜绿假单胞菌（10.5%）、肺炎链球菌（9.9%）和流感嗜血杆菌（9.4%）。肺癌患者院内感染院内死亡率为21.1%（36/171）。多因素Logistic回归分析结果显示:住院期间接受过机械通气、存在感染性休克以及低蛋白血症是影响肺癌患者院内感染预后的独立危险因素（P＜0.05）。结论:肺癌患者院内感染发生率及死亡率较高，且受多种因素影响，临床应采取积极有效的措施，以改善患者预后。

Microbiological characteristics and prognostic factors of nosocomial infections in patients with lung cancer

Objective:To evaluate the clinical characteristics,microbiological characteristics,and prognostic factors of nosocomial infections in patients with lung cancer.Methods:We retrospectively analyzed clinical data of 171 lung cancer patients complicated with nosocomial infections who admitted to the cancer treatment center of our hospital from August 2013 to June 2019,and counted the incidence,microbiological characteristics,in-hospital mortality,and prognostic factors of nosocomial infections in these patients.Results:Among the 1 008 patients with lung cancer,171(17.0%) patients developed nosocomial infections,with respiratory tract infection being the most common one,accounting for 76.0% of all cases.The isolated pathogens included Gram-negative bacteria,fungi,and Gram-positive bacteria.Candida albicans was the most common isolated causative pathogen,accounting for 14.6%,followed by Klebsiella pneumoniae (12.9%),Pseudomonas aeruginosa (10.5%),Streptococcus pneumoniae (9.9%),and Haemophilus spp.(9.4%).The in-hospital mortality of nosocomial infections in patients with lung cancer was 21.1%(36/171).The multivariate Logistic analysis showed that mechanical ventilation,existence of septic shock,and hypoproteinemia were independent risk factors for prognosis of nosocomial infections in patients with lung cancer (P＜0.05).Conclusion:The incidence and in-hospital mortality of nosocomial infections in lung cancer patients is considerably high and associated with a variety of factors.Rapidly and effective measures should be taken to improve the prognosis of nosocomial infections in these patients.