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目的分析从肺癌术后患者分离的病原菌特征,为术后感染的预防和治疗提供病原学依据。方法回顾性分析2009年1月至2011年12月华西医院收治的159例肺癌术后患者的病原微生物学资料,其中男142例,女17例;平均年龄(61.8±9.6)岁。按常规方法留取标本进行菌种鉴定和体外药敏试验。结果病原菌主要分离自患者痰液标本(90.6%,155/171)。常见菌种依次为白色念珠菌(25.7%,44/171)、肺炎克雷伯菌(15.2%,26/171)、鲍曼/醋酸钙不动杆菌复合体(13.4%,23/171)和铜绿假单胞菌(8.2%,14/171)。39.1%(9/23)的鲍曼/醋酸钙不动杆菌复合体分离株为多重耐药菌株,23.1%(6/26)的肺炎克雷伯菌分离株产生超广谱β-内酰胺酶,铜绿假单胞菌分离株对抗菌药物保持较高的体外敏感性。结论肺癌术后患者的病原菌主要分离自痰液标本,白色念珠菌及革兰阴性杆菌是主要病原菌,应作为术后感染预防与治疗的重要目标。
Objective To analyze the characteristics of pathogens isolated from postoperative lung cancer patients and provide etiological basis for postoperative infection prevention and treatment. Methods We retrospectively analyzed the pathogenic microbiological data of 159 lung cancer patients admitted to West China Hospital from January 2009 to December 2011. Among them, 142 were males and 17 were females; the average age was (61.8±9.6) years. Samples were taken according to conventional methods for strain identification and in vitro drug susceptibility testing. Results The pathogens were mainly isolated from patients’ sputum specimens (90.6%, 155/171). Common species were Candida albicans (25.7%, 44/171), Klebsiella pneumoniae (15.2%, 26/171), Baumann/Acinetobacter acetate complex (13.4%, 23/171) and Pseudomonas aeruginosa (8.2%, 14/171). 39.1% (9/23) of the Bowman/Acinetobacter calcareus complex isolates were multidrug resistant strains, and 23.1% (6/26) of Klebsiella pneumoniae isolates produced extended-spectrum β-lactamases. , Pseudomonas aeruginosa isolates maintained high in vitro sensitivity to antibiotics. Conclusion The pathogens of postoperative lung cancer patients were mainly isolated from sputum specimens. Candida albicans and gram-negative bacilli were the main pathogens and should be taken as important targets for postoperative infection prevention and treatment.