Characteristics of Pathogens from Lung Cancer Patients with Infection after Surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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HE Chao , GUO Peiling , KANG Mei

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Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, P. R. China

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Abstract: Objective To analyze the characteristics of pathogens isolated from patients with lung cancer after surgery, and provide instructions for the prevention and treatment of postoperative infection. Methods A retrospective investigation of the pathogenic microbiology data of 159 patients（142 males and 17 females with average age at 61.8±9.6 years) with lung cancer after surgery in West China Hospital from January 2009 to December 2011 was performed.We got the specimen from the patients by routine methods, identified the pathogens, and conducted drug susceptibility tests in vitro. Results The pathogens were mainly isolated from sputum of the patients （90.6%, 155/171）. Canidia albicans（25.7%, 44/171）, Klebsiella pneumonia（15.2%, 26/171）, Acinetobacter calcoaceticus-A. baumannii（13.4%, 23/171）and Pseudomonas aeruginosa（8.2%, 14/171） were the predominant species. Among A. calcoaceticus-A. baumannii isolates, 39.1%（9/23） of them were multidrug resistant strains. And 23.1%（6/26）of K. pneumonia isolates produced extended spectrum beta-lactamases. P. aeruginosa isolates showed high in vitro susceptibility to the antibacterial agents. Conclusion Pathogens are mainly isolated from sputum of patients after surgery for lung cancer. Canidia albicans and gram-negative bacilli are predominant isolates and should be the major targets for the prevention and treatment of postoperative infection.

Citation： HE Chao,GUO Peiling,KANG Mei,et al .. Characteristics of Pathogens from Lung Cancer Patients with Infection after Surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(2): 145-144. doi: Copy

1.	2 Yamada Y, Sekine Y, Suzuki H, et al. Trends of bacterial colonisation and the risk of postoperative pneumonia in lung cancer patients with chronic obstructive pulmonary disease. Eur J Cardiothorac Surg, 2010, 37（4）：752-757.
2.	3 Alifano M, Regnard JF. Postoperative pneumonia in lung cancer.
3.	patients：chronic obstructive pulmonary disease, preoperative bronchial colonisation and antibioprophylaxis are critical issues. Eur J.
4.	Cardiothorac Surg, 2010, 37（4）：750-751.
5.	4 雷艺炎, 陈振光, 罗红鹤, 等. 肺癌患者围术期并发症发生的危险.
6.	因素分析. 中国胸心血管外科临床杂志, 2008, 15（4）：268-271.
7.	5 Strand TE, Rostad H, Damhuis RA, et al. Risk factors for 30-day mortality after resection of lung cancer and prediction of their magnitude. Thorax, 2007, 62（11）：991-997.
8.	6 中华人民共和国卫生部医政司. 全国临床检验操作规程. 第3版. 南京：东南大学出版社, 2006. 736-920.
9.	7 CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-First Informational Supplement. CLSI document M100-S21. Wayne, PA：Clinical and laboratory standards institute, 2011.
10.	8 Lanoix JP, Pluquet E, Lescure FX, et al. Bacterial infection profiles in lung cancer patients with febrile neutropenia. BMC Infect Dis, 2011, 11：183-189.
11.	9 Mizgerd JP. Acute lower respiratory tract infection. N Engl J Med, 2008, 358（7）：716-727.
12.	Wren SM, Martin M, Yoon JK, et al. Postoperative pneumonia-prevention program for the inpatient surgical ward. J Am Coll Surg, 2010, 210（4）：491-495.
13.	沈春辉，车国卫. 肺康复在肺癌围手术期应用现状与进展. 中国康复医学杂志, 2011, 26（7）：686-689.
14.	温昱鹏, 张鹏. 肺癌术后肺感染的相关因素分析. 天津医科大学学报, 2009, 15（3）：411-412.
15.	Schussler O, Alifano M, Dermine H, et al. Postoperative pneumonia after major lung resection. Am J Respir Crit Care Med, 2006, 173（10）：1161-1169.
16.	Radu DM, Jaureguy F, Seguin A, et al. Postoperative pneumonia after major pulmonary resections：an unsolved problem in thoracic surgery. Ann Thorac Surg, 2007, 84（5）：1669-1673.
17.	雷莉莉. 肺癌晚期合并肺部感染的临床研究. 临床肺科杂志, 2011, 16（10）：1559-1660.
18.	谭秦湘, 周明强. 80例肺癌患者伴肺部感染的痰培养与药敏试验结果分析. 中国当代医药, 2011, 18（21）：112-113.
19.	唐琼, 冯赵陆. 肺癌并发肺部感染患者外周血T淋巴细胞亚群水平研究. 中华医院感染学杂志, 2011, 21（17）：3600-3602.
20.	Pathak AK, Creppage KE, Werner JR, et al. Immune regulation of a chronic bacteria infection and consequences for pathogen transmission. BMC Microbiol, 2010, 10：226-234.
21.	Humphreys H, Newcombe RG, Enstone J, et al. Four country healthcare-associated infection prevalence survey：pneumonia and lower respiratory tract infections. J Hosp Infect, 2010, 74（3）：266-270.
22.	Karageorgopoulos DE, Falagas ME. Current control and treatment of multidrug-resistant acinetobacter baumannii infections. Lancet Infect Dis, 2008, 8（12）：751-762.
23.	Dijkshoorn L, Nemec A, Seifert H. An increasing threat in hospitals：multidrug-resistant Acinetobacter baumannii. Nat Rev Microbiol, 2007, 5（12）：939-951.
24.	Lorente L. The management of acute lower respiratory tract infection. Minerva Med, 2008, 99（5）：459-481.

1. 2 Yamada Y, Sekine Y, Suzuki H, et al. Trends of bacterial colonisation and the risk of postoperative pneumonia in lung cancer patients with chronic obstructive pulmonary disease. Eur J Cardiothorac Surg, 2010, 37（4）：752-757.
2. 3 Alifano M, Regnard JF. Postoperative pneumonia in lung cancer.
3. patients：chronic obstructive pulmonary disease, preoperative bronchial colonisation and antibioprophylaxis are critical issues. Eur J.
4. Cardiothorac Surg, 2010, 37（4）：750-751.
5. 4 雷艺炎, 陈振光, 罗红鹤, 等. 肺癌患者围术期并发症发生的危险.
6. 因素分析. 中国胸心血管外科临床杂志, 2008, 15（4）：268-271.
7. 5 Strand TE, Rostad H, Damhuis RA, et al. Risk factors for 30-day mortality after resection of lung cancer and prediction of their magnitude. Thorax, 2007, 62（11）：991-997.
8. 6 中华人民共和国卫生部医政司. 全国临床检验操作规程. 第3版. 南京：东南大学出版社, 2006. 736-920.
9. 7 CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-First Informational Supplement. CLSI document M100-S21. Wayne, PA：Clinical and laboratory standards institute, 2011.
10. 8 Lanoix JP, Pluquet E, Lescure FX, et al. Bacterial infection profiles in lung cancer patients with febrile neutropenia. BMC Infect Dis, 2011, 11：183-189.
11. 9 Mizgerd JP. Acute lower respiratory tract infection. N Engl J Med, 2008, 358（7）：716-727.
12. Wren SM, Martin M, Yoon JK, et al. Postoperative pneumonia-prevention program for the inpatient surgical ward. J Am Coll Surg, 2010, 210（4）：491-495.
13. 沈春辉，车国卫. 肺康复在肺癌围手术期应用现状与进展. 中国康复医学杂志, 2011, 26（7）：686-689.
14. 温昱鹏, 张鹏. 肺癌术后肺感染的相关因素分析. 天津医科大学学报, 2009, 15（3）：411-412.
15. Schussler O, Alifano M, Dermine H, et al. Postoperative pneumonia after major lung resection. Am J Respir Crit Care Med, 2006, 173（10）：1161-1169.
16. Radu DM, Jaureguy F, Seguin A, et al. Postoperative pneumonia after major pulmonary resections：an unsolved problem in thoracic surgery. Ann Thorac Surg, 2007, 84（5）：1669-1673.
17. 雷莉莉. 肺癌晚期合并肺部感染的临床研究. 临床肺科杂志, 2011, 16（10）：1559-1660.
18. 谭秦湘, 周明强. 80例肺癌患者伴肺部感染的痰培养与药敏试验结果分析. 中国当代医药, 2011, 18（21）：112-113.
19. 唐琼, 冯赵陆. 肺癌并发肺部感染患者外周血T淋巴细胞亚群水平研究. 中华医院感染学杂志, 2011, 21（17）：3600-3602.
20. Pathak AK, Creppage KE, Werner JR, et al. Immune regulation of a chronic bacteria infection and consequences for pathogen transmission. BMC Microbiol, 2010, 10：226-234.
21. Humphreys H, Newcombe RG, Enstone J, et al. Four country healthcare-associated infection prevalence survey：pneumonia and lower respiratory tract infections. J Hosp Infect, 2010, 74（3）：266-270.
22. Karageorgopoulos DE, Falagas ME. Current control and treatment of multidrug-resistant acinetobacter baumannii infections. Lancet Infect Dis, 2008, 8（12）：751-762.
23. Dijkshoorn L, Nemec A, Seifert H. An increasing threat in hospitals：multidrug-resistant Acinetobacter baumannii. Nat Rev Microbiol, 2007, 5（12）：939-951.
24. Lorente L. The management of acute lower respiratory tract infection. Minerva Med, 2008, 99（5）：459-481.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Characteristics of Pathogens from Lung Cancer Patients with Infection after Surgery

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