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目的分析老年肺癌下呼吸道感染患者痰培养物的病原菌分布及耐药状况。方法回顾性分析407例老年肺癌下呼吸道感染患者痰标本细菌培养、鉴定及药敏结果。结果共分离出病原菌238株,革兰阴性菌163株,占68.49%;革兰阳性菌33株,占13.87%;真菌42株,占17.65%。主要病原菌为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌、表皮葡萄球菌和金黄色葡萄球菌。其中,肺炎克雷伯菌和大肠埃希菌ESBLs阳性菌株的比例分别为36.73%、28.85%。结论老年肺癌患者因长期使用抗生素,呼吸道菌群失调,不同病原菌对抗菌药耐药率均较高,以革兰阴性菌感染为主,肺炎克雷伯菌和大肠埃希菌产ESBLs的菌株有较高比例,二重感染比例较高;革兰阳性菌均对万古霉素敏感,未发现耐药菌株。因此临床医生根据药敏结果合理选用抗生素,对于改善患者肺部微生态失衡,延长生存时间具有重要指导意义。
Objective To analyze the distribution and drug resistance of pathogens in sputum cultures of elderly patients with lung cancer with lower respiratory tract infection. Methods The bacterial culture, identification and drug susceptibility of sputum specimens from 407 elderly patients with lung cancer with lower respiratory tract infection were retrospectively analyzed. Results A total of 238 pathogenic bacteria were isolated, 163 of which were Gram-negative bacteria, accounting for 68.49%; 33 of Gram-positive bacteria, accounting for 13.87%; 42 of fungi, accounting for 17.65%. The main pathogens are Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus epidermidis and Staphylococcus aureus. Among them, the proportion of Klebsiella pneumoniae and Escherichia coli ESBLs positive strains were 36.73%, 28.85% respectively. Conclusion Elderly patients with lung cancer due to long-term use of antibiotics, respiratory tract dysbacteriosis, different pathogenic bacteria resistant to antibacterials were higher, with gram-negative bacteria infection, Klebsiella pneumoniae and Escherichia coli produce ESBLs strains A higher proportion of double infection rate is higher; gram-positive bacteria are sensitive to vancomycin, no drug-resistant strains were found. Therefore, the rational selection of antibiotics by clinicians based on drug susceptibility results has important guiding significance for improving patients’ lung microecological imbalance and prolonging survival time.