晚期肿瘤患者下呼吸道感染临床分析

目的：探讨晚期肿瘤患者下呼吸道感染的细菌学分类情况及抗生素耐药性特点。方法：采用回顾性调查107例晚期肿瘤患者并下呼吸道感染痰菌分离的病原菌并分析其特点，药敏试验采用K—B纸片法。结果：137株病原菌，G杆菌67株(48．9％)．G^ 球菌44株(32．1%)，真菌26株(19．0％)。主要致病细菌依次为铜绿假单胞菌19．7％．金黄色葡萄球菌13．9％，肺炎克雷伯菌10．9％。万古霉素、新霉素、环丙沙星对G^ 球菌较敏感；环丙沙星、阿米卡星、头孢哌酮对G杆菌作用较强．其他抗菌药物对各种病原菌均呈现不同程度的耐药。结论：晚期恶性肿瘤并下呼吸道感染的病原菌多为条件致病菌，耐药率高。应加强病原菌培养及药敏监测，以指导临床科学使用抗生素。

SPUTUM CULTURE AND DRUG SENSITIVITY OF PATHOGENS IN ADVANCED CANCER PATIENTS WITH LOWER RESPIRATORY TRACT INFECTION

Objective:To investigate the distribut io n and drug sensitivity of bacteria from advanced cancer patients with lower resp iratory tract infection.Methods:Retrospective study of prem cultures of sputum specimen s in advanced cancer patients with lower respiratory tract infection.Drug sensit ivity was tested by Kirby-Bauer disk sensitivity method.Results:67 of 137 strains were Gram negative bacillin(48 9%),4 4 strains were Gram positive cocci(32 1%) and fungi(19 0%) The predominant pat hogens were Pseudomonas aeruginosa (19 7%),Staphylococcus(13 9%),K lebsiella( 10 9%) Norvancomycin,neomycin and ciprofloxacin were the most active agents ag ainst Gram positive cocci.Ciprofloxacin amikacin and cefperazone were the most a ctive agents against Gram negative bacillin.The others were drug fast against cl inical isolates in defferent degrees. Conclusions:The conditioned pathogenic bacteria were the major p athogens in advanced cancer patients with lower respiratory tract infection and most of them resisted to antibiotics.Sputum culture and drug sensitivity should be seriously considered and reasonble application of antibiotics should be empha sized.