气道支架置入术后相关肺部感染的 病原学分析与抗感染对策
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(福建医科大学附属泉州第一医院,福建 泉州 362000)

作者简介:

郭伟峰,男,副主任医师,主要研究方向是气管镜介入治疗,肺癌诊疗方面。

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R 563.9

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泉州市科技计划项目资助课题(2018Z089)


Etiological Analysis and Anti-infection Strategies of Related Lung Infections after Airway Stent Placement
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(The Quanzhou First Hospital Affi liated to Fujian Medical University, Fujian Quanzhou 362000)

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    摘要:

    〔摘 要〕 目的:对气道支架置入术后相关肺部感染的病原学特点进行分析,并总结抗感染对策。方法:从 2017 年 2 月 至 2020 年 12 月在福建医科大学附属泉州第一医院治疗的气道支架植入术后肺部感染患者中随机选取 54 例作为研究对象, 对其临床资料进行回顾性分析,分析患者下呼吸道分泌物微生物培养的病原菌类型以及药敏试验结果。结果:患者的下呼 吸道分泌物微生物培养结果显示,所有患者均为阳性(100.00 %),共分离出病原菌 65 株;其中铜绿假单胞菌的分离率 (30.77 %)最高,其次为金黄色葡萄球菌(20.00 %),溶血性葡萄球菌(1.54 %)、近平滑念珠菌(1.54 %)最低;金黄色葡萄球菌对红霉素、青霉素 G、克林霉素、阿米卡星等耐药,对替考拉宁、复方新诺明、万古霉素、苯唑西林、利奈唑胺、 头孢唑啉等较为敏感;铜绿假单胞菌对美罗培南、头孢唑啉、左氧氟沙星、奈替米星等耐药,大肠埃希菌对庆大霉素、亚胺培南、 他唑巴坦钠、美罗培南等耐药。结论:患者行气道支架植入术治疗后,发生相关肺部感染的几率较高,并且肺部感染的病 原菌主要以革兰氏阴性菌为主,临床治疗人员应结合病原菌培养结果以及患者的生理病理状态,对治疗过程进行优化,降 低术后相关肺炎的发生率。

    Abstract:

    〔Abstract〕 Objective To analyze the etiological characteristics of related lung infections after airway stent placement, and to summarize anti-infection strategies. Methods From February 2017 to December 2020, 54 patients with pulmonary infection after airway stent implantation treated in Quanzhou First Hospital affi liated to Fujian Medical University were randomly selected as the research object, and their clinical data were retrospectively reviewed Analyze and analyze the types of pathogenic bacteria cultured by the microorganisms of the lower respiratory tract secretions of patients and the results of drug sensitivity tests. Results The results of the microbial culture of the lower respiratory tract secretions of the patients showed that all patients were positive in 54 cases (100.00%), and a total of 65 pathogenic bacteria were isolated; among them, the isolation rate of Pseudomonas aeruginosa was the highest, followed by golden grapes. 20.00% of cocci, 1.54% of hemolytic staphylococci, and 1.54% of Candida parapsilosis are the lowest; Staphylococcus aureus is resistant to erythromycin, penicillin G, clindamycin, amikacin, etc., and is resistant to teicoplanin, Compound trimethoprim, vancomycin, oxacillin, linezolid, cefazolin, etc. are more sensitive; Pseudomonas aeruginosa is resistant to meropenem, cefazolin, levofl oxacin, netilmicin, etc., Escherichia coli The bacteria are resistant to gentamicin, imipenem, tazobactam sodium, and meropenem. Conclusion After patients undergoing airway stent implantation, the risk of related lung infections is higher, and the pathogenic bacteria of lung infections are mainly Gram-negative bacteria. The clinical treatment staff should combine the results of pathogen culture and the patient's Physiological and pathological conditions, some treatment procedures are optimized to reduce the incidence of postoperative related pneumonia.

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  • 收稿日期:2021-05-18
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  • 在线发布日期: 2021-10-25
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