| 王 鹏,张 东,郭学光,孙宝君,方向群,郭英华,曲歌平,刘长庭.老年非小细胞肺癌患者肺部感染病原学分布与耐药性分析[J].,2017,17(32):6260-6266 |
| 老年非小细胞肺癌患者肺部感染病原学分布与耐药性分析 |
| Analysis of Distribution and Drug Resistance Profile of Pathogens isolated from Sputum Samples of Elderly Non-small Cell Lung Cancer Patients Accompanied with Pneumonia |
| 投稿时间：2017-03-30 修订日期：2017-04-23 |
| DOI：10.13241/j.cnki.pmb.2017.32.012 |
| 中文关键词: 老年人 非小细胞肺癌 痰培养 病原菌 耐药性 |
| 英文关键词: Elderly Non-small cell lung cancer Sputum culture Pathogen Drug resistance |
| 基金项目:国家重点基础研究发展计划资助(973计划)(2014CB744400) |
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| 中文摘要: |
| 摘要 目的：探讨老年非小细胞肺癌患者并发肺部感染的病原菌种类及药敏情况。方法：对2010年1月至2015年12月在我院老年病房收治的82例不可手术非小细胞肺癌(NSCLC)并发肺部感染患者及101例院内获得性肺炎（HAP）患者的痰培养阳性结果进行统计分析，包括病原菌分布及耐药特征分析。结果：NSCLC组共分离菌株187株，HAP组分离313株，其中革兰氏阴性菌分别为99株(52.9%) 和198株(63.3%)，分离真菌分别为53株(28.3%)和63株(20.1%)，两组对比均有统计学显著性差异(p=0.023，p=0.035)。NSCLC组白色念珠菌分离率显著高于HAP组(15.4% vs. 6.4%, p<0.001)。两组分离革兰氏阳性菌分别是35株(18.8%)和52株(16.6%)，分离率无统计学差异。对NSCLC组病原菌的耐药谱分析表明，革兰阴性菌多表现为多重耐药，革兰氏阳性菌和真菌对常用抗菌药敏感性高。结论：老年不可手术NSCLC合并肺部感染主要以革兰阴性菌为主，且耐药率较高，NSCLC组患者真菌分离率高于HAP患者，根据药敏结果合理应用抗生素是治疗的关键。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the pathogenic bacteria and drug sensitivity in elderly patients with non-small cell lung cancer (NSCLC) complicated with pulmonary infection. Methods: Positive results of sputum culture in 82 patients with unresectable non-small cell lung cancer complicated with pulmonary infection and 101 patients with hospital acquired pneumonia (HAP) were analyzed retrospectively from Jan.2010 to Dec. 2015 in our geriatric ward. Statistical analysis included the distribution and drug resistance of pathogens. Results: There were 187 and 313 strains were isolated respectively from NSCLC and HAP patents’ sputum. Among them, 99 strains (52.9%) and 198 strains (63.3%) were gram negative bacteria, 53 (28.3%) and 63(20.1%) strains were identified as fungi, respectively. The two groups were statistically significant difference (p=0.023, p=0.035, respectively). The isolation rate of Candida albicans in NSCLC group was significantly higher than that in HAP group (15.4% vs. 6.4%, p <0.001). There were 35(18.8%) and 52 (16.6%) strains Gram-positive bacteria were isolated from two groups respectively and no significant difference in the isolation rate. Detailed analyze of the resistance profile in NSCLC group patients revealed that multi-drug resistance were commonly seen among gram-negative bacteria. Most gram-positive bacteria and fungi detected were susceptive to common antibiotics and anti-fungi agents. Conclusion: Gram-negative bacteria are the main pathogens in elderly NSCLC complicated with pulmonary infection patients and the drug resistance rate was high. The isolation rate of fungi was significant higher within NSCLC group than HAP patients. The key to its treatment is the rational use of antibiotics according to their drug sensitivity test. |
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