摘要
目的 分析腹腔镜胃癌根治术后患者肺部感染病原菌分布特征及耐药现状,为临床合理使用抗生素提供依据。方法 选取行腹腔镜手术后肺部感染的胃癌患者62例,通过对患者痰液标本进行细菌培养,并进行药敏试验,综合分析病原菌分布情况以及主要致病菌的耐药性。结果 62例术后患者痰液标本中共检出88株病原菌;革兰阴性菌占59.09%(52/88):大肠埃希菌占18.18%(16/88),铜绿假单胞菌13.64%(12/88),肺炎克雷伯菌占10.23%(9/88),阴沟肠杆菌占7.95%(7/88),鲍曼不动杆菌占4.55%(4/88),其他占4.55%(4/88);革兰阳性菌占29.55%(26/88):金黄色葡萄球菌占11.36%(10/88),溶血性葡萄球菌占7.95%(7/88),表皮葡萄球菌占5.68%(5/88),其他占4.55%(4/88);真菌占11.36%(10/88),白色链球菌占5.68%(5/88),热带念珠菌3.41%(3/88),其他占2.27%(2/88);大肠杆菌对头孢曲松、头孢吡肟和复方新诺明耐药率较高,对亚胺培南、头孢哌酮和环丙沙星的耐药率较低;铜绿假单胞菌对头孢曲松、头孢吡肟和复方新诺明耐药率较高,对亚胺培南、头孢哌酮和环丙沙星的耐药率较低;金黄色葡萄球菌对青霉素、克林霉素、头孢哌酮和复方新诺明耐药率较高,对万古霉素和四环素耐药率较低;溶血性葡萄球菌对青霉素、克林霉素和复方新诺明耐药率较高,对万古霉素、头孢哌酮和四环素耐药率较低。结论 腹腔镜胃癌根治术后患者肺部感染病原菌分布复杂,对经验性抗菌药物耐药率较高,临床医生需根据病原菌感染特征和药敏实验使用耐药率较低抗菌药物有效进行对症治疗。
Objective To analyze the distribution of pulmonary infection after laparoscopic gastric cancer and provide a basis for rational clinical use of antibiotics.Methods 62 patients with lung infection after laparoscopic radical gastrectomy for gastric cancer were selected.Sputum specimens were cultured and bacteria identified,and drug sensitivity test was carried out.Then the etiological structure and profile of drug resistance of causative agents were analyzed thoroughly.Results A total of 88 strains of pathogenic bacteria were isolated from the sputum samples of 62 patients.Of these strains,Gram-negative bacteria accounted for 59.09%(52/88)of isolates,including 16 strains of Escherichia coli(18.18%,16/88),12 strains of Pseudomonas aeruginosa(13.64%,12/88),9 strains of Klebsiella pneumoniae(10.23%,9/88),7 strains of Enterobacter cloacae(7.95%,7/88),4 strains of Acinetobacter baumannii(4.55%,4/88)and 4 strains of others(4.55%,4/88).Gram-positive bacteria accounted for 29.55%(26/88)of isolates,including 10 strains of Staphylococcus aureus(11.36%,10/88),7 strains of Staphylococcus haemolyticus(7.95%,7/88),5 strains of Staphylococcus epidermidis(5.68%,5/88),and 4 strains of others(4.55%,4/88).Fungi accounted for 11.36%(10/88)of isolates,including 5 strains of Candida albicans(5.68%,5/88),3 strains of Candida tropicalis(3.41%,3/88),and 2 strains of others(2.27%,2/88).Escherichia coli showed high resistance to ceftriaxone,cefepime and compound sulfamethoxazole and low resistance to imipenem,cefoperazone and ciprofloxacin.Pseudomonas aeruginosa showed high resistance to ceftriaxone,cefepime and compound sulfamethoxazole and low resistance to imipenem,cefoperazone and ciprofloxacin.Staphylococcus aureus had high resistance to penicillin,clindamycin,cefoperazone and compound sulfamethoxazole,and low resistance to vancomycin and tetracycline.Staphylococcus haemolyticus showed high resistance to penicillin,clindamycin,and compound sulfamethoxazole and low resistance to vancomycin,cefoperazone,and tetracycline.Conclusion The lung infections of patients after laparoscopic radical gastrectomy are caused by complex pathogenic bacteria,which have a high resist-ance rate to empirical antimicrobial drugs,so clinicians need to use antimicrobial drugs with a low resistance rate according to the characteristics of pathogenic bacteria and drug sensitivity experiments to effectively carry out symptomatic treatment.
作者
李燕
牛桂林
朱金玉
孙洋
苏颖
徐真
闫小燕
LI Yan;NIU Guilin;ZHU Jinyu(Nanyang Central Hospital,Nanyang,473000)
出处
《实用癌症杂志》
2025年第6期993-996,共4页
The Practical Journal of Cancer
关键词
腔镜胃癌
肺部感染
病原菌
分布特征
耐药性
Laparoscopic gastrectomy
Lung infection
Pathogenic bacteria
Distribution characteristics
Drug resistance
