Microbial etiology, susceptibility profile of postradiation nasopharyngeal necrosis patients with nasopharyngeal carcinoma
Microbial etiology, susceptibility profile of postradiation nasopharyngeal necrosis patients with nasopharyngeal carcinoma
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鼻咽癌放射后鼻咽坏死患者的微生物病原学、易感性分析
DOI：
10.1016/j.canrad.2019.09.008
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发表时间：
2020-04-01
影响因子：
1.3
通讯作者：
Tu, Zi-Wei
中科院分区：
文献类型：
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作者：
Wang, Li;Yang, Jun;Tu, Zi-Wei
Objective. - 放射后鼻咽坏死（PRNN）是影响鼻咽癌（NPC）患者放疗后预后的常见并发症。临床医生必须认识到这一问题，以科普这一严峻的临床形势。我们研究的目的是评估PRNN的细菌学，并证明抗菌药物的敏感性模式，应指导临床医生更适当的抗生素使用。- 回顾性入组了2013年3月至2017年12月期间在我科接受PRNN的69例NPC患者。对69例PRNN患者进行病原学培养和药敏试验。根据结果分析病原菌感染率及药物敏感性。- 69例伴有PRNN的NPC患者入选本研究。在58例（84%）患者中确定了病原体。在58例患者中，34例（58.6%）患者分离出金黄色葡萄球菌。其次是铜绿假单胞菌。药敏结果显示左氧氟沙星最高（88.5%），其次为环丙沙星（85.2%）和庆大霉素（80.3%）。致病真菌以白色念珠菌为主，占6.8%。PRNN患者的细菌和真菌培养阳性率与患者的性别、年龄、分期、放疗疗程数无显著性差异（P > 0.05），但细菌和真菌培养阴性患者的治愈率高于细菌和真菌培养阳性患者（63.6%vs20.7%，P = 0.011）。- 我们的研究结果提供了PRNN NPC患者的微生物学和药物敏感模式的总体情况，可以帮助实施更合理的治疗和改善治疗结果的指南。(C)2020法国放射治疗肿瘤学会（SFRO）。由Elsevier Masson SAS出版。All rights reserved.
Objective. - Postradiation nasopharyngeal necrosis (PRNN) is a notorious complication after radiotherapy that affects prognosis in patients with nasopharyngeal carcinoma (NPC). It is important for clinical doctors to realize this problem in order to cope with this severe clinical situation. The aim of our study was to assess the bacteriology of PRNN and to demonstrate the antimicrobial susceptibility pattern that should guide the clinicians towards more appropriate antibiotic use.Methods. - Sixty-nine NPC patients with PRNN in our department between March 2013 and December 2017 were retrospectively enrolled. Pathogenic culture and drug sensitivity test were performed in these 69 NPC patients with PRNN. The infection rate of Pathogens and the sensitivity of the drugs were analyzed based on these results.Results. - Sixty-nine NPC patients with PRNN were enrolled in our study. Pathogens were identified in 58 (84%) patients. Of the 58 patients, Staphylococcus aureus was isolated in 34 (58.6%) patients. And the second most common group of bacterial isolates was Pseudomonas aeruginosa. Antibiotic sensitivity showed that Levofloxacin was the highest (88.5%), followed by Ciprofloxacin (85.2%) and Gentamicin(80.3%). The only pathologic fungus was Candida albicans, about 6.8%. The positive rates of bacterial and fungal culture in PRNN patients were not significantly different from the patients' gender, age, stage, number of radiotherapy courses (P > 0.05), but the cure rate was statistically higher in culture-negative patients in comparison with culture-positive patients (63.6% vs 20.7%, P = 0.011).Conclusion. - Our results provide an overall picture of the microbiology and drug susceptibility patterns for NPC patients with PRNN and could help implement guidelines for more rational treatment and improve therapeutic outcome. (C) 2020 Societe francaise de radiotherapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.