摘要
目的探究乳腺癌术后巩固化疗患者感染病原菌及其危险因素预测模型。方法以2019年12月-2022年12月于中国医科大学附属盛京医院进行术后巩固化疗的乳腺癌患者159例为研究对象,根据感染情况分为感染组(n=26)及非感染组(n=133);统计感染病原菌,归纳乳腺癌术后巩固化疗患者感染的危险因素,并建立预测模型。结果26例感染患者共培养分离病原菌26株,以铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌为主;主要革兰阴性菌对青霉素、头孢唑林、阿莫西林的耐药率较高,金黄色葡萄球菌对万古霉素较敏感;呼吸道感染占比高于皮肤软组织、口腔黏膜等部位(P<0.05);糖尿病和化疗周期≥3是乳腺癌术后巩固化疗患者感染的危险因素(P<0.05);预测模型P=1/[1+e^((-1.034+0.474×糖尿病+0.531×化疗周期≥3个))];Hosmer-Lemeshow检验显示,Hosmer-Lemeshowχ^(2)=0.698,P=0.573;经受试者工作特征(ROC)曲线分析得,预测模型预测乳腺癌术后巩固化疗患者感染的曲线下面积(AUC)为0.866。结论乳腺癌术后巩固化疗患者以革兰阴性菌感染为主,基于危险因素建立的预测模型对患者感染情况具有预测价值。
OBJECTIVE To investigate the infectious pathogens in patients undergoing postoperative consolidation chemotherapy for breast cancer and their prediction model of risk factors.METHODS A total of 159 patients with postoperative consolidation chemotherapy for breast cancer in Shengjing Hospital Affiliated to China Medical University between Dec.2019 and Dec.2022 were selected as the study subjects,and were divided into the infection group(n=26)and the non-infection group(n=133)according to the infection status.The infectious pathogens were statistically analyzed,the risk factors for the infections in patients undergoing postoperative consolidation chemotherapy for breast cancer were summarized,and a prediction model was established.RESULTS A total of 26 strains of pathogenic bacteria were cultured and isolated from 26 infected patients,predominated by Pseudomonas aeruginosa,Klebsiella pneumoniae and Staphylococcus aureus.The main pathogenic bacteria were more resistant to penicillin,cefazolin and amoxicillin,and more sensitive to vancomycin.Respiratory tract accounted for a higher percentage than that of the skin,soft tissue,oral mucosa and other part of the skin(P<0.05).Diabetes mellitus and the cycle of chemotherapy over than 3 were the risk factors for infection in patients undergoing postoperative consolidation chemotherapy for breast cancer after(P<0.05).The prediction model was as follow:P=1/[1+e^((-1.034+0.474×diabetes mellitus+0.531× chemotherapy cycle over than 3))].The results of Hosmer-Lemeshow test were as follows:Hosmer-Lemeshowχ^(2)=0.698,P=0.573.ROC curves analysis showed that the area under the curve(AUC)of the model for predicting infection in patients undergoing postoperative consolidation chemotherapy for breast cancer was 0.866.CONCLUSION The main pathogen of infection was gram-negative bacteria in patients undergoing postoperative consolidation chemotherapy for breast cancer,and a prediction model based on risk factors had predictive value for the occurrence of infection.
作者
侯晓丹
马玉
刘丽华
金安
杨古月
HOU Xiao-dan;MA Yu;LIU Li-hua;JIN An;YANG Gu-yue(Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning110000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第20期3089-3093,共5页
Chinese Journal of Nosocomiology
基金
辽宁省科研基金资助项目(2020L02121)。
关键词
乳腺癌
手术治疗
化疗
感染特点
危险因素
预测模型
Breast cancer
Surgical treatment
Chemotherapy
Infection characteristic
Risk factor
Prediction model
作者简介
侯晓丹(1989-),女,本科,护师,研究方向:乳腺肿瘤诊治;通讯作者:杨古月,E-mail:659791066@qq.com。
