摘要
目的分析急诊肿瘤晚期感染患者的病原菌分布及炎性指标变化的意义,为提高临床诊断治疗效果提供客观依据。方法选取2015年1月-2016年12月医院急诊收治的89例晚期肿瘤合并感染患者作为研究对象,对患者感染部位进行观察和分析,对患者感染分泌物样本中的病原菌分布及耐药性进行检测和分析,对患者入院时血样本中炎症标志物水平进行检测和比较。结果 89例感染患者共检出94株病原菌,以革兰阴性菌为主,共53株占56.4%;主要革兰阴性菌对环丙沙星、磺胺甲噁唑/甲氧苄啶的耐药率较高,对阿米卡星较为敏感;革兰阴性菌感染患者的血浆降钙素原(PCT)、C-反应蛋白(CRP)、脂多糖(LPS)水平均高于革兰阳性菌感染患者(P<0.05)。结论急诊肿瘤晚期合并感染患者的感染部位、病原菌分布及耐药性、炎症指标变化均具有一定的特征,临床医生应给予高度的重视、密切的监测及有效的诊治,以提高感染的诊治效果,改善患者的预后。
OBJECTIVE To analyze the distribution of pathogenic bacteria and the significance of inflammatory indexes changes in patients with advanced cancer complicated with infections in emergency department,so as to provide an objective basis for promoting the effects of clinical diagnosis and treatment.METHODS A total of 89 cases of patients with advanced cancer complicated with infections in emergency department from Jan.2015 to Dec.2016 were selected as the research subjects.The infected sites of the patients were observed and analyzed.The distribution and drug resistance of pathogenic bacteria in the secretions samples of the patients were detected and analyzed.The inflammatory markers levels in the blood samples of the patients on admission were detected and compared.RESULTS Totally 94 strains of pathogenic bacteria were detected from 89 infected patients,which were mainly 53 strains of gram-negative bacteria,accounting for 56.4%.The drug resistant rates of main gram-negative bacteria to ciprofloxacin and sulfamethoxazole/trimethoprim were high and they were sensitive to amikacin.The plasma inflammatory markers levels（PCT,CRP and LPS）of the patients with gram-negative bacteria infections were significantly higher than those of the patients with gram-positive bacteria infections（P〈0.05）.CONCLUSION The infected sites,distribution and drug resistance of pathogenic bacteria,and inflammatory indexes of the patients with advanced cancer complicated with infections in emergency department have certain characteristics.The clinicians should give high priority,close monitoring and effective treatments in order to improve the diagnosis and treatment of infection,and improve the prognosis of the patients.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第23期5348-5351,共4页
Chinese Journal of Nosocomiology
关键词
急诊
肿瘤晚期
感染
病原菌分布
炎性指标
Emergency department
Advanced cancer
Infection
Pathogenic bacteria distribution
Inflammatoryindexes
