非小细胞肺癌放化疗患者医院感染病原菌与耐药性及T淋巴细胞亚群变化

朱跃; 周建国; 卢文芬; 王艳丽; 全建; 芦苇; 俞红林; 曹倩; 王玉

doi:10.11816/cn.ni.2025-241053

非小细胞肺癌放化疗患者医院感染病原菌与耐药性及T淋巴细胞亚群变化

Pathogenic bactepria, drug resistance and T lymphocyte subsets for hospital-associated infection in non-small cell lung cancer patients treated with radio-chemotherapy

摘要

摘要:
目的探究非小细胞肺癌放化疗患者医院感染致病菌分布、药敏结果及T淋巴细胞亚群变化，为其及早干预和防控提供依据。
方法选取中国贵航集团302医院2020年1月-2024年3月收治的80例非小细胞肺癌放化疗合并医院感染患者纳入感染组，85例非小细胞肺癌放化疗未合并医院感染患者纳入未感染组；统计感染组致病菌分布及主要致病菌的药敏结果情况；比较两组CD₃⁺、CD₄⁺、CD₈⁺、CD₄⁺/CD₈⁺、辅助性T细胞17(Th17)、调节性T细胞(Treg)、Th17/Treg水平。
结果 80例非小细胞肺癌放化疗医院感染患者检出病原菌91株，革兰阴性菌占比最高，肺炎克雷伯菌是主要的革兰阴性菌，金黄色葡萄球菌是主要的革兰阳性菌；肺炎克雷伯菌、金黄色葡萄球菌分别对头孢唑林、青霉素耐药性较高，对美罗培南、万古霉素敏感性较高；感染组CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺、Treg的水平是(62.37±11.25)%、(36.53±9.61)%、(1.43±0.41)、(1.48±0.37)%均低于未感染组，CD₈⁺、Th17、Th17/Treg的水平是(25.64±4.84)%、(4.67±0.85)%、(3.15±0.78)高于未感染组(P < 0.05)。
结论革兰阴性菌为非小细胞肺癌放化疗医院感染患者的主要病原菌，肺炎克雷伯菌、金黄色葡萄球菌引起的感染分别推荐使用美罗培南、万古霉素，非小细胞肺癌放化疗医院感染患者细胞免疫功能较弱。

Abstract:
OBJECTIVE To investigate the distribution of pathogenic bacteria, drug sensitivity and T lymphocyte subsets for hospital-acquired infection in patients with non-small cell lung cancer (NSLC)treated with radio-chemotherapy, and to provide evidence for early intervention and prevention.
METHODS A total of 80 patients with NSLC treated with radio-chemotherapy combined with hospital-acquired infection in China Guihang Corporate 302 Hospital from Jan. 2020 to Mar. 2024 were selected as the infection group, and 85 patients with NSLC treated with radio-chemotherapy without hospital-acquired infection were selected as the non-infection group. The distribution and drug sensitivity of pathogenic bacteria in the infection group were analyzed. The levels of CD₃⁺, CD₄⁺, CD₈⁺, CD₄⁺/CD₈⁺, T helper cell 17 (Th17), regulatory T cell (Treg) and Th17/Treg were compared between the two groups.
RESULTS A total of 91 strains of pathogenic bacteria were detected in the infection group, in which the proportion of gram-negative bacteria was the largest. Klebsiella pneumoniae was the most common gram-negative bacteria isolated, and Staphylococcus aureus was the most common gram-positive bacteria. K. pneumoniae was highly resistant to cefazolin and sensitive to meropenem; S. aureus was highly resistant to penicillin and sensitive to vancomycin. The levels of CD₃⁺, CD₄⁺, CD₄⁺/CD₈⁺ and Treg in the infection group were (62.37±11.25) %, (36.53±9.61) %, (1.43±0.41) and (1.48±0.37) %, respectively, which were lower than those in the non-infection group; while the levels of CD₈⁺, Th17 and Th17/Treg in the infection group were (25.64±4.84) %, (4.67±0.85) % and (3.15±0.78), respectively, which were higher than those in the non-infection group (P < 0.05).
CONCLUSIONS Gram-negative bacteria are the main pathogens in patients with NSLC treated with radio-chemotherapy combined with hospital-aquired infection, whose cellular immune function impaires. Meropenem and vancomycin are recommended for infection caused by K. pneumoniae and S. aureus.

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非小细胞肺癌放化疗患者医院感染病原菌与耐药性及T淋巴细胞亚群变化

Pathogenic bactepria, drug resistance and T lymphocyte subsets for hospital-associated infection in non-small cell lung cancer patients treated with radio-chemotherapy

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