中晚期肺癌患者肺部真菌感染的临床特点及耐药性分析

摘要

目的 研究中晚期肺癌患者肺部真菌感染的相关因素及检出菌株的药敏试验结果.方法 选取2012年1月至2016年4月该院收治的84例中晚期肺癌患者作为研究对象,分析肺癌患者真菌感染的危险因素,记录患者的病原菌株及检出菌株的药敏试验结果.结果 84例患者中真菌感染17例(20.24%),年龄大于75岁(OR=1.879)、住院时间超过2周(OR=2.095)、侵入性操作(OR=2.885)、高血压(OR=1.983)、糖尿病(OR=2.217)及贫血(OR=2.190)是中晚期肺癌患者肺部真菌感染的危险因素(P<0.05).17例感染者检出17株真菌,检出真菌以假丝酵母菌属为主,占88.24%.检出的白色假丝酵母菌和克柔假丝酵母菌属对氟康唑、伊曲康唑及伏立康唑耐药率较高,其中白色假丝酵母菌耐药率分别为20.00%、20.00%及30.00%,克柔假丝酵母菌耐药率分别为50.00%、50.00%及50.00%,热带假丝酵母菌对伏立康唑的耐药率为100.00%.结论 临床上应重视高危肺癌患者的感染预防工作,并慎重选择敏感的抗真菌药物.%Objective To analyze the relating factors of fungal infection in patients with advanced lung cancer,as well to study the drug resistance of detected strains.Methods From January 2012 to April 2016,84 cases of advanced lung cancer patients were chosen as study objects.The relating factors of fungal infection were analyzed.The results of pathogen examination and drug resistance were recorded.Results In 84 patients,17 patients(20.24%) were diagnosed with fungal infection,>75 years old(OR=1.879),length of stay>2 weeks(OR=2.095),invasive operation(OR=2.885),hypertension(OR=1.983),anemia(OR=2.190)and diabetes mellitus(OR=2.217)were risk factors of pulmonary fungal infections in patients with advanced lung cancer(P<0.05).17 strains were detected in 17 cases of infection,the main strains were Candida spp.,accounting for 88.24%.The drug-resistant rates of candida albicans to fluconazole,itraconazol and voriconazole were respectively 20.00%,20.00% and 30.00%;drug-resistant rates of candida krusei to fluconazole,itraconazol and voriconazole were respectively 50.00%,50.00% and 50.00%;drug-resistant rates of candida tropicalis to voriconazole were 100.00%.Conclusion Clinical attention should be paid to the prevention of infection in patients with high-risk lung cancer,and careful selection of sensitive antifungal agents.