Distribution and drug-susceptibility of pathogens in patients with pulmonary infection after esophageal carcinoma operation

doi:10.3877/cma.j.issn.1674-1358.2017.01.012

Abstract

Abstract:

Objective

To investigate the distribution and drug-susceptibility of pathogens in patients with esophageal cancer combined with postoperative pulmonary infection and to improve the reference of rational clinical drug use and the control of hospital infection.

Methods

Total of 141 cases with esophageal cancer combined with pulmonary infection in Cardiothoracic Surgery, Affiliated Hospital of North Sichuan Medical College from June 2013 to May 2015 were selected randomly, the clinical data were analyzed, retrospectivly. The strains classification and drug susceptibility were detected.

Results

Total of 249 strains of pathogenic bacterias were found from 141 patients with pulmonary infection after esophageal carcinoma operation. Most strains were Gram-negative bacteria (204 strains, 81.93%), among which Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii and Escherichia coli were dominant pathogens with the isolation rate of 15.26%, 14.06%, 13.25% and 10.04%, respectively. Gram-positive bacteria were detected with 41 strains (16.46%), among which Staphylococcus aureus, excrement Enterococcus (group D) and angina Streptococcus were relatively common with the isolation rate of 5.62%, 3.61% and 2.81%, respectively. The rate of fungus detection rate was low, with only 4 strains (1.61%). Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae showed high susceptibility to levofloxacin and impenem, the antibiotic sensitive rates were 68.00%-100.00%. Escherichia coli showed high susceptibility to impenem and ceftazidime, the antibiotic sensitive rates were over 90.00%. Staphylococcus aureus, excrement Enterococcus (group D) and angina Streptococcus showed high susceptibility to vancomycin, tigecycline and penicillin, the antibiotic sensitive rates were nearly 100.00%.

Conclusions

Gram-negative bacteria was the commom pathogenic bacteria of pulmonary infection after esophagectomy, levofloxacin and impenem could be used in anti-infection treatment empirically; Secondly, pulmonary infection could be caused by Gram-positive bacteria. Vancomycin or penicillin could be used in anti-infection treatment empirically.

Key words: Esophageal carcinoma operation, Pulmonary infection, Pathogen, Susceptibility test

Heyi Tan, Shengjun Tang, Yongqiang Luo, Gaowu Yan, Yulei Wang, Jing Xie, Tingting Huang, Yinglong Lai. Distribution and drug-susceptibility of pathogens in patients with pulmonary infection after esophageal carcinoma operation[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(01): 56-59.

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References 20

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病原菌		株数	构成比（%）
革兰阳性菌		41	16.46
	金黄色葡萄球菌	14	5.62
	屎肠球菌（D群）	9	3.61
	溶血葡萄球菌	6	2.41
	咽峡炎链球菌	7	2.81
	肺炎链球菌	5	2.01
革兰阴性菌		204	81.93
	铜绿假单胞菌	38	15.26
	鲍曼不动杆菌	33	13.25
	肺炎克雷伯菌	35	14.06
	大肠埃希菌	25	10.04
	洋葱伯克霍尔德菌	19	7.63
	流感嗜血杆菌	19	7.63
	臭鼻克雷伯菌	8	3.21
	普通变形菌	3	1.21
	嗜麦芽窄食单胞菌	5	2.00
	摩根摩根菌	3	1.21
	阴沟肠杆菌	8	3.21
	黏液型铜绿假单胞菌	3	1.21
	卡他布兰汉菌	3	1.21
	琼氏不动杆菌	2	0.80
真菌
	白假丝酵母菌	4	1.61
合计		249	100.00

病原菌		株数	构成比（%）
革兰阳性菌		41	16.46
	金黄色葡萄球菌	14	5.62
	屎肠球菌（D群）	9	3.61
	溶血葡萄球菌	6	2.41
	咽峡炎链球菌	7	2.81
	肺炎链球菌	5	2.01
革兰阴性菌		204	81.93
	铜绿假单胞菌	38	15.26
	鲍曼不动杆菌	33	13.25
	肺炎克雷伯菌	35	14.06
	大肠埃希菌	25	10.04
	洋葱伯克霍尔德菌	19	7.63
	流感嗜血杆菌	19	7.63
	臭鼻克雷伯菌	8	3.21
	普通变形菌	3	1.21
	嗜麦芽窄食单胞菌	5	2.00
	摩根摩根菌	3	1.21
	阴沟肠杆菌	8	3.21
	黏液型铜绿假单胞菌	3	1.21
	卡他布兰汉菌	3	1.21
	琼氏不动杆菌	2	0.80
真菌
	白假丝酵母菌	4	1.61
合计		249	100.00

抗菌药物	铜绿假单胞菌（n = 38）		鲍曼不动杆菌（n = 33）		肺炎克雷伯菌（n = 35）		大肠埃希菌（n = 25）
抗菌药物	株数	敏感性（%）	株数	敏感性（%）	株数	敏感性（%）	株数	敏感性（%）
左氧氟沙星	32	84.00	24	72.73	35	100.00	0	0.00
亚胺培南	26	68.42	18	54.55	33	94.29	25	100.00
庆大霉素	14	36.84	15	45.45	4	11.43	3	12.00
复方新诺明	0	0.00	7	21.21	0	0.00	1	4.00
呋喃妥因	0	0.00	0	0.00	2	5.71	—	—
头孢替坦	2	5.26	0	0.00	—	—	17	68.00
头孢唑啉	0	0.00	2	6.06	1	2.86	0	0.00
米诺环素	—	—	29	87.88	—	—	—	—
头孢他啶	1	2.60	0	0.00	34	97.14	23	92.00
头孢吡肟	21	55.26	1	3.03	25	71.43	20	80.00
氨苄西林	3	7.89	0	0.00	0	0.00	0	0.00

抗菌药物	铜绿假单胞菌（n = 38）		鲍曼不动杆菌（n = 33）		肺炎克雷伯菌（n = 35）		大肠埃希菌（n = 25）
抗菌药物	株数	敏感性（%）	株数	敏感性（%）	株数	敏感性（%）	株数	敏感性（%）
左氧氟沙星	32	84.00	24	72.73	35	100.00	0	0.00
亚胺培南	26	68.42	18	54.55	33	94.29	25	100.00
庆大霉素	14	36.84	15	45.45	4	11.43	3	12.00
复方新诺明	0	0.00	7	21.21	0	0.00	1	4.00
呋喃妥因	0	0.00	0	0.00	2	5.71	—	—
头孢替坦	2	5.26	0	0.00	—	—	17	68.00
头孢唑啉	0	0.00	2	6.06	1	2.86	0	0.00
米诺环素	—	—	29	87.88	—	—	—	—
头孢他啶	1	2.60	0	0.00	34	97.14	23	92.00
头孢吡肟	21	55.26	1	3.03	25	71.43	20	80.00
氨苄西林	3	7.89	0	0.00	0	0.00	0	0.00

抗菌药物	金黄色葡萄球菌（n = 14）		屎肠球菌（D群）（n = 9）		咽峡炎链球菌（n = 7）
抗菌药物	株数	敏感性（%）	株数	敏感性（%）	株数	敏感性（%）
替加环素	11	78.57	9	100.00	—	—
利福平	5	35.71	8	88.89	—	—
四环素	4	28.57	5	55.56	0	0.00
万古霉素	14	100.00	7	77.78	4	57.14
利奈唑胺	3	21.43	3	33.33	—	—
呋喃妥因	1	7.14	—	—	—	—
青霉素	0	0.00	0	0.00	7	100.00
头孢噻肟	—	—	—	—	6	85.71
氨苄西林	—	—	0	0.00	—	—
左氧氟沙星	0	0.00	0	0.00	—	—

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