摘要
目的探讨并发肺感染的晚期肺癌患者致病菌谱分布特点及多重病原菌感染影响因素。方法选取2020年3月-2022年3月在南阳市中心医院治疗的晚期肺癌合并肺部感染患者200例,其中多重病原菌感染66例,单一病原菌感染134例,所有患者给予细菌培养和药敏试验,同时比较多重病原菌和单一病原菌感染患者临床资料差异。结果共检出病原菌314株,革兰阴性菌以肺炎克雷伯菌(n=91)、鲍曼不动杆菌(n=52)为主,革兰阳性菌以金黄色葡萄球菌(n=25)为主,真菌以白假丝酵母菌(n=17)为主。肺炎克雷伯菌对亚胺培南无耐药性;鲍曼不动杆菌对阿米卡星、亚胺培南、妥布霉素和头孢曲松无耐药性;金黄色葡萄球菌对阿米卡星、庆大霉素、妥布霉素无耐药性;白假丝酵母菌对伊曲康唑无耐药性。多重病原菌感染患者年龄≥50岁、肿瘤、淋巴结、转移(TNM)分期Ⅳ期、有糖尿病、有慢性阻塞性肺疾病、有侵入性操作比例分别为69.70%、62.12%、43.94%、33.33%、46.97%,明显高于单一病原菌感染患者(28.36%、38.81%、15.67%、10.45%、16.42%),差异均有统计学意义(χ^(2)=31.021、9.663、18.845、15.961、21.191,P均<0.05)。Logistic回归分析结果显示,年龄、TNM分期、糖尿病、慢性阻塞性肺疾病和侵入性操作是患者多重病原菌感染的影响因素(OR=1.968、2.452、2.809、2.512、2.173,P均<0.05)。结论在晚期肺癌合并肺部感染患者中,病原菌感染以革兰阴性菌为主,同时仍有较高比例患者发生多重病原菌感染;多重病原菌感染受患者年龄、TNM分期等因素影响。
Objective To investigate the distribution characteristics of pathogenic bacteria and influencing factors of multiple pathogen infection in advanced lung cancer complicated with lung infection.Methods A total of 200 patients with advanced lung cancer complicated with pulmonary infection treated in the Nanyang Central Hospital from March 2020 to March 2022 were selected,including 66 cases of multiple pathogen infection and 134 cases of single pathogen infection;bacterial culture and drug sensitivity test were performed for all patients,and the clinical data of patients with multiple pathogens and single pathogen infection were compared.Results A total of 314 strains of pathogenic bacteria were detected;Gram-negative bacteria were mainly Klebsiella pneumoniae(n=91)and Acinetobacter baumannii(n=52),Gram-positive bacteria were mainly Staphylococcus aureus(n=25),and fungi were mainly Candida albicans(n=17).Klebsiella pneumoniae was not resistant to imipenem;Acinetobacter baumannii was not resistant to amikacin,imipenem,tobramycin and ceftriaxone.Staphylococcus aureus was not resistance to amikacin,gentamicin and tobramycin;Candida albicans was not resistant to itraconazole.The proportion of patients with multiple pathogen infection with age≥50 years old,tumor node metastasis(TNM)stage IV,diabetes,chronic obstructive pulmonary disease and invasive operation were 69.70%,62.12%,43.94%,33.33%and 46.97%,respectively,which was significantly higher than those with single pathogen infection(28.36%,38.81%,15.67%,10.45%,16.42%),the differences were statistically significant(χ^(2)=31.021,9.663,18.845,15.961,21.191;all P<0.05).Logistic regression analysis showed that age,TNM stage,diabetes,chronic obstructive pulmonary disease and invasive operation were the influencing factors of multiple pathogen infection(OR=1.968,2.452,2.809,2.512,2.173;all P<0.05).Conclusions In patients with advanced lung cancer complicated with pulmonary infection,Gram-negative bacteria were the main pathogens,and a high proportion of patients had multiple pathogen infections.Multiple pathogenic bacteria infection was affected by age,TNM stage and other factors.
作者
刘培培
许学宗
孙潺
张轩斌
崔艳红
张凯
LIU Peipei;XU Xuezong;SUN Chan;ZHANG Xuanbin;CUI Yanhong;ZHANG Kai(Department of Respiratory and Critical Care Medicine,Nanyang Central Hospital,Nanyang,Henan 473000,China;Department of Radiotherapy,Nanyang Central Hospital,Nanyang,Henan 473000,China)
出处
《热带医学杂志》
CAS
2023年第12期1699-1703,共5页
Journal of Tropical Medicine
基金
国家科技支撑计划之数字诊疗装备研发(2016YFC0105700)
关键词
晚期肺癌
肺部感染
病原菌
药敏试验
多重病原菌感染
Advanced lung cancer
Pulmonary infection
Pathogenic bacteria
Drug sensitivity test
Multiple pathogen infection
作者简介
刘培培(1987-),女,硕士,研究方向:呼吸与危重症、肺部恶性肿瘤,E-mail:liu123450822@163.com
