CAJ | 학술논문

目的：了解我院老年肺癌患者呼吸道感染鲍曼不动杆菌耐药情况并探讨引起鲍曼不动杆菌感染的相关因素。方法采用χ2检验对2011年1月至2012年12月呼吸道鲍曼不动杆菌感染的老年肺癌患者(肺癌组)51例和68例非肿瘤患者发生呼吸道鲍曼不动杆菌感染者(对照组)进行易感相关因素、抗生素耐药性情况分析。结果肺癌组患者呼吸道鲍曼不动杆菌感染菌株对抗生素的耐药与住院时间、广谱抗生素使用、激素应用和呼吸道侵入性操作密切相关。与对照组比较，4种因素差异均有显著统计学意义(P<0.01)。鲍曼不动杆菌对多种抗生素耐药，与对照组比较，肺癌组抗生素耐药率较高，其中对阿米卡星、庆大霉素、头孢噻肟和头孢他啶等10种抗生素耐药性差异有统计学意义(P<0.01)。结论老年肺癌患者呼吸道感染的鲍曼不动杆菌对多种抗生素有较高的耐药率，应加强对鲍曼不动杆菌耐药性监测，指导临床合理使用抗生素，缩短住院抗生素使用时间，减少激素应用和侵入性操作，预防和减少鲍曼不动杆菌感染与耐药菌株的产生和传播。
목적：료해아원노년폐암환자호흡도감염포만불동간균내약정황병탐토인기포만불동간균감염적상관인소。방법채용χ2검험대2011년1월지2012년12월호흡도포만불동간균감염적노년폐암환자(폐암조)51례화68례비종류환자발생호흡도포만불동간균감염자(대조조)진행역감상관인소、항생소내약성정황분석。결과폐암조환자호흡도포만불동간균감염균주대항생소적내약여주원시간、엄보항생소사용、격소응용화호흡도침입성조작밀절상관。여대조조비교，4충인소차이균유현저통계학의의(P<0.01)。포만불동간균대다충항생소내약，여대조조비교，폐암조항생소내약솔교고，기중대아미잡성、경대매소、두포새우화두포타정등10충항생소내약성차이유통계학의의(P<0.01)。결론노년폐암환자호흡도감염적포만불동간균대다충항생소유교고적내약솔，응가강대포만불동간균내약성감측，지도림상합리사용항생소，축단주원항생소사용시간，감소격소응용화침입성조작，예방화감소포만불동간균감염여내약균주적산생화전파。
Objective To investigate the drug-resistance and the risk factors of respiratory tract Acinetobacter baumannii (ABA) infection in aged patients with lung cancer in our hospital. Methods A retrospective analysis withχ2 test on risk factors and drug-resistance to ABA was conducted in 51 aged lung cancer patients with ABA infection (lung cancer group) from January 2011 to December 2012, and in 68 non-cancer patients with ABA infection during the corresponding period (the control group). Results The main cause of ABA infection in aged patients with lung cancer was closely related to staying long time in hospital, the application of broad-spectrum antibiotic, the application of hormone and respiratory tract invasive nursing procedures. Compared with control group, there were statistically significant difference among the 4 factors (P<0.01). The rates of resistance to different antibiotics in the lung cancer group were relatively higher, especially for 10 antibiotics including Amikacin, Gentamicin, Cefotaxime, Ceftazidime (P<0.01). Conclusion Acinetobacter baumannii (ABA) infection in aged patients with lung cancer had high drug-re-sistance against many antibiotics. In order to prevent and reduce ABA infection and drug-resistant strains spread, we should strengthen the routine monitoring of antibiotics resistance, shorten patients’length of hospital stay, reduce inva-sive procedures and use hormone reasonably.