摘要
目的:分析胸部恶性肿瘤放化疗并发感染患者送检标本主要感染的病原菌种类、分布及耐药性。方法:选取2022年1月—2024年12月在涟水县人民医院收治的胸部恶性肿瘤放化疗并发感染患者送检的1731例标本,统计送检标本类型及病原菌检测阳性率,并对感染的主要病原菌进行培养,统计药敏结果,分析病原菌分布及其耐药性。结果:1731例标本中阳性标本289例,阳性率为16.7%,其中痰液950例,阳性率为20.42%(194/950);静脉全血687例,阳性率为7.86%(54/687);咽拭子22例,阳性率为27.27%(6/22);脓液20例,阳性率为85.00%(17/20);尿液10例,阳性率为40.00%(4/10)。289例阳性标本中共检测出314株病原菌,其中革兰氏阴性菌256株,占81.5%,居前三位的是肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌;革兰氏阳性菌58株,占18.5%,居前三位的是金黄色葡萄球菌、表皮葡萄球菌、人葡萄球菌。肺炎克雷伯菌对头孢吡肟耐药率为21.9%,对头孢他啶的耐药率为18.8%;铜绿假单胞菌对氨苄西林/舒巴坦、复方新诺明和氯霉素的耐药率为52.8%;大肠埃希菌对复方新诺明的耐药率为65.5%。金黄色葡萄球菌对青霉素的耐药率为100%,其次对克林霉素和红霉素的耐药率为75.0%;表皮葡萄球菌对苯唑西林、红霉素和青霉素的耐药率为100%;人葡萄球菌对红霉素和青霉素的耐药率为100%,对苯唑西林和克林霉素的耐药率较高。结论:胸部恶性肿瘤放化疗并发感染患者送检标本中脓液标本的阳性率最高,临床应增加脓液标本的采集,送检标本感染的病原菌主要为革兰氏阴性菌,且耐药形势不容忽视,应定期对病原菌的分布及耐药情况进行监测分析,为临床抗感染治疗提供依据。
Objective:To analyze the types,distribution and drug resistance of the main pathogenic bacteria in the specimens submitted by patients with malignant tumors of the chest undergoing radiotherapy and chemotherapy complicated with infection.Method:A total of 1,731 specimens submitted by patients with malignant tumors of the chest underwent radiotherapy and chemotherapy complicated with infection who were admitted to the People's Hospital of Lianshui from January 2022 to December 2024 were selected.The types of submitted specimens and the positive rate of pathogen detection were statistically analyzed.The main pathogenic bacteria of infection were cultured,the drug sensitivity results were statistically analyzed,and the distribution of pathogenic bacteria and their drug resistance were analyzed.Result:Among 1,731 specimens,289 specimens were positive,with a positive rate of 16.7%.Among them,there were 950 cases of sputum,with a positive rate of 20.42%(194/950).There were 687 cases of venous whole blood,with a positive rate of 7.86%(54/687).There were 22 cases of throat swabs,with a positive rate of 27.27%(6/22).There were 20 cases of pus,with a positive rate of 85.00%(17/20).There were 10 cases of urine,with a positive rate of 40.00%(4/10).A total of 314 pathogenic bacteria were detected in 289 positive specimens,among which 256 were Gram-negative bacteria,accounting for 81.5%.The top three were Klebsiella pneumoniae,Pseudomonas aeruginosa and Escherichia coli.There were 58 Grampositive bacteria,accounting for 18.5%.The top three were Staphylococcus aureus,Staphylococcus epidermidis and Staphylococcus hominis.The resistance rate of Klebsiella pneumoniae to Cefepime was 21.9%,and the resistance rate to Ceftazidime was 18.8%.The resistance rate of Pseudomonas aeruginosa to Ampicillin/Sulbactam,Compound Sulfamethoxazole and Chloramphenicol was 52.8%.The resistance rate of Escherichia coli to Compound Sulfamethoxazole was 65.5%.The resistance rate of Staphylococcus aureus to Penicillin was 100%,followed by the resistance rates to Clindamycin and Erythromycin,which were 75.0%.The resistance rate of Staphylococcus epidermidis to Oxacillin,Erythromycin and Penicillin was 100%.The resistance rate of Staphylococcus hominis to Erythromycin and Penicillin was 100%,and the resistance rate to Oxacillin and Clindamycin was relatively high.Conclusion:The positive rate of pus specimens in patients with malignant tumors of the chest undergoing radiotherapy and chemotherapy complicated with infection is the highest.Clinically,the collection of pus specimens should be increased.The main pathogenic bacteria causing infection in the submitted specimens are Gram-negative bacteria,and the drug resistance situation cannot be ignored.Regular monitoring and analysis of the distribution and drug resistance of pathogenic bacteria should be conducted to provide a basis for clinical anti-infection treatment.
作者
侯盼飞
孙文娟
HOU Panfei;SUN Wenjuan(Department of Laboratory Medicine,the People's Hospital of Lianshui,Lianshui 223400,China;不详)
出处
《中国医学创新》
2025年第36期137-142,共6页
Medical Innovation of China
基金
江苏护理职业学院科教融汇临床科研课题(SH202410250105)
南京医科大学康达学院科研发展基金课题(KD2024KYJJ181)。
关键词
胸部恶性肿瘤
病原菌
感染
耐药性
Malignant tumors of the chest
Pathogenic bacteria
Infected
Drug resistance
