恶性肿瘤患者铜绿假单胞菌血流感染的临床资料分析
|
摘要
目的探讨恶性肿瘤患者铜绿假单胞菌血流感染的影响因素。方法选择医院治疗的恶性肿瘤合并铜绿假单胞菌血流感染患者60例和同时间段内医院就诊的恶性肿瘤未合并有铜绿假单胞菌血流感染患者60例作为研究对象,分析恶性肿瘤患者铜绿假单胞菌血流感染的影响因素。结果年龄偏大,住院时间较长,合并其他部位感染和使用2种以上抗菌药物四种因素为恶性肿瘤患者罹患铜绿假单胞菌血流感染的独立影响因素(P<0.05),恶性肿瘤患者血液感染铜绿假单胞菌对于多数常用抗菌药物的敏感度较高,其中对于阿米卡星和妥布霉素的敏感度达到85.00%,对于氨曲南的敏感度最低,为61.67%,发生铜绿假单胞菌血流感染的患者共有37例在2周内死亡,病死率为61.67%,其余23例患者经过对症处理后恢复,2周内未出现死亡。结论恶性肿瘤患者出现由铜绿假单胞菌导致的血流感染后,病死率非常高,需要对各类独立影响因素进行具有针对性的预防和控制,减少该种感染的发生,提升患者的生存质量。
OBJECTIVE To explore the influencing factors for Pseudomonas aeruginosa bloodstream infection in the malignant tumor patients.METHODS Totally 60 malignant tumor patients complicated with P.aeruginosa bloodstream infection and 60 malignant tumor patients without P.aeruginosa bloodstream infection were recruited as the study objects.The influencing factors for the P.aeruginosa bloodstream infection in the malignant tumor patients were analyzed.RESULTS The old age,long length of hospital stay,complication with other sites of infections and use of more than 2 types of antibiotics were the independent influencing factors for the P.aeruginosa bloodstream infection in the malignant tumor patients(P<0.05).The P.aeruginosa strains causing the bloodstream infection in the malignant tumor patients were highly susceptible to most of the commonly used antibiotics,the drug susceptibility rates to amikacin and tobramycin were as high as 85.00%,while the drug susceptibility rate to aztreonam was the lowest(61.67%).Totally 37 patients who had the P.aeruginosa bloodstream infection died within 2 weeks,with the mortality rate 61.67%,and the rest of 23 patients did not die within 2 weeks after symptomatic treatment.CONCLUSION The mortality rate of the malignant tumor patients who have P.aeruginosa bloodstream infection is extensively high.It is necessary to take targeted prevention measures according to the independent influencing factors so as to reduce the incidence of the infection and improve the quality of life of the patients.
OBJECTIVE To explore the influencing factors for Pseudomonas aeruginosa bloodstream infection in the malignant tumor patients.METHODS Totally 60 malignant tumor patients complicated with P.aeruginosa bloodstream infection and 60 malignant tumor patients without P.aeruginosa bloodstream infection were recruited as the study objects.The influencing factors for the P.aeruginosa bloodstream infection in the malignant tumor patients were analyzed.RESULTS The old age,long length of hospital stay,complication with other sites of infections and use of more than 2 types of antibiotics were the independent influencing factors for the P.aeruginosa bloodstream infection in the malignant tumor patients(P<0.05).The P.aeruginosa strains causing the bloodstream infection in the malignant tumor patients were highly susceptible to most of the commonly used antibiotics,the drug susceptibility rates to amikacin and tobramycin were as high as 85.00%,while the drug susceptibility rate to aztreonam was the lowest(61.67%).Totally 37 patients who had the P.aeruginosa bloodstream infection died within 2 weeks,with the mortality rate 61.67%,and the rest of 23 patients did not die within 2 weeks after symptomatic treatment.CONCLUSION The mortality rate of the malignant tumor patients who have P.aeruginosa bloodstream infection is extensively high.It is necessary to take targeted prevention measures according to the independent influencing factors so as to reduce the incidence of the infection and improve the quality of life of the patients.
引文
[1]徐忠良,张辉,王德征,等.2015年天津市户籍居民恶性肿瘤死亡及去死因期望寿命分析[J].中华流行病学杂志,2017,38(2):231-234.
[2]Kim A,Im M,Yim NH,et al.The novel herbal cocktail MA128suppresses tumor growth and the metastatic potential of highly malignant tumor cells[J].Oncol Rep,2015,34(2):900-912.
[3]Hangai S,Nannya Y,Kurokawa M.Role of procalcitonin and C-reactive protein for discrimination between tumor fever and infectionin patients with hematological diseases[J].Leuk Lymphoma,2015,56(4):910-914.
[4]Byun JM,Lee CK,Rhee SY,et al.Risks for opportunistic tuberculosis infection in a cohort of 873patients with inflammatory bowel disease receiving a tumor necrosis factor-αinhibitor[J].Scand J Gastroenterol,2015,50(3):312-320.
[5]陈胜兰,祝春亚,周华,等.利奈唑胺治疗耐甲氧西林金黄色葡萄球菌血流感染的效果及安全性[J].中华医学杂志,2017,97(14):1084-1088.
[6]Cardoso TM,Machado A,Costa DL,et al.Protective and pathological functions of CD8+T cells in Leishmaniabraziliensis infection[J].Infect Immun,2015,83(3):898-906.
[7]中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320.
[8]CLSI.Performance standards for antimicrobial susceptibility testing:twenty-third informational supplement:M100-S23[S].Wayne,PA:CLSI,2013:461-465.
[9]卫国,赵飞骏,张河林,等.粤北地区铜绿假单胞菌的临床分布和耐药性特点[J].国际检验医学杂志,2017,38(1):21-23.
[10]谷俊莹,周芮,程新,等.贵州省某三甲医院ICU患者铜绿假单胞菌感染的耐药性分析[J].贵州医药,2017,41(3):278-280.
[11]Mayer-Hamblett N,Kloster M,Rosenfeld M,et al.Impact of sustained eradication of new Pseudomonas aeruginosa infection on long-term outcomes in cystic fibrosis[J].Clin Infect Dis,2015,61(5):707-715.
[12]刘桢宇,陈春林,徐荣,等.我院2015年病原菌分布情况及耐药性分析[J].中国药房,2017,28(11):1475-1478.
[13]Moore JE,Rendall JC,Downey DG.Pseudomonas aeruginosa displays an altered phenotype in vitro when grown in the presence of mannitol[J].Br J Biomed Sci,2015,72(3):115-119.
[14]王仙,徐传新.铜绿假单胞菌致肺部感染合并血液感染患者的药学监护[J].医药导报,2017,36(2):220-222.
[15]Iyer R,Erwin AL.Direct measurement of efflux in Pseudomonas aeruginosa using an environment-sensitive fluorescent dye[J].Res Microbiol,2015,166(6):516-524.
[2]Kim A,Im M,Yim NH,et al.The novel herbal cocktail MA128suppresses tumor growth and the metastatic potential of highly malignant tumor cells[J].Oncol Rep,2015,34(2):900-912.
[3]Hangai S,Nannya Y,Kurokawa M.Role of procalcitonin and C-reactive protein for discrimination between tumor fever and infectionin patients with hematological diseases[J].Leuk Lymphoma,2015,56(4):910-914.
[4]Byun JM,Lee CK,Rhee SY,et al.Risks for opportunistic tuberculosis infection in a cohort of 873patients with inflammatory bowel disease receiving a tumor necrosis factor-αinhibitor[J].Scand J Gastroenterol,2015,50(3):312-320.
[5]陈胜兰,祝春亚,周华,等.利奈唑胺治疗耐甲氧西林金黄色葡萄球菌血流感染的效果及安全性[J].中华医学杂志,2017,97(14):1084-1088.
[6]Cardoso TM,Machado A,Costa DL,et al.Protective and pathological functions of CD8+T cells in Leishmaniabraziliensis infection[J].Infect Immun,2015,83(3):898-906.
[7]中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320.
[8]CLSI.Performance standards for antimicrobial susceptibility testing:twenty-third informational supplement:M100-S23[S].Wayne,PA:CLSI,2013:461-465.
[9]卫国,赵飞骏,张河林,等.粤北地区铜绿假单胞菌的临床分布和耐药性特点[J].国际检验医学杂志,2017,38(1):21-23.
[10]谷俊莹,周芮,程新,等.贵州省某三甲医院ICU患者铜绿假单胞菌感染的耐药性分析[J].贵州医药,2017,41(3):278-280.
[11]Mayer-Hamblett N,Kloster M,Rosenfeld M,et al.Impact of sustained eradication of new Pseudomonas aeruginosa infection on long-term outcomes in cystic fibrosis[J].Clin Infect Dis,2015,61(5):707-715.
[12]刘桢宇,陈春林,徐荣,等.我院2015年病原菌分布情况及耐药性分析[J].中国药房,2017,28(11):1475-1478.
[13]Moore JE,Rendall JC,Downey DG.Pseudomonas aeruginosa displays an altered phenotype in vitro when grown in the presence of mannitol[J].Br J Biomed Sci,2015,72(3):115-119.
[14]王仙,徐传新.铜绿假单胞菌致肺部感染合并血液感染患者的药学监护[J].医药导报,2017,36(2):220-222.
[15]Iyer R,Erwin AL.Direct measurement of efflux in Pseudomonas aeruginosa using an environment-sensitive fluorescent dye[J].Res Microbiol,2015,166(6):516-524.