Clinical Characteristics,Pathogenic Bacteria Distribution and High Risk Factors of Postoperative Pulmonary Infection in Patients with Lung Cancer
Objective To investigate the clinical characteristics,pathogenic bacteria distribution and high risk factors of postoperative pulmonary infection in patients with lung cancer.Methods Clinical data of 373 patients with lung cancer treated by thoracoscopic surgery in Anyang Cancer Hospital from January 2020 to April 2023 were retrospectively collected.According to the occurrence of postoperative lung infection,the patients were divided into an infected group(109 cases)and a non-infected group(264 cases)according to whether they had postoperative pulmonary infection.The distribution and clinical characteristics of pathogenic bacteria in patients with postoperative lung cancer complicated with pulmonary infection were analyzed,and the high-risk factors for postoperative pulmonary infections in lung cancer patients were analyzed by multivariate logistic regression.Results A total of 125 strains of pathogenic bacteria were isolated from 109 patients with pulmonary infection after lung cancer surgery,of which 75 strains(60.00％)were Gram-negative.The main pathogenic bacteria were Pseudomonas aeruginosa(19.20％)and Acinetobacter baumannii(15.20％).There were 44 strains of Gram-positive bacteria(35.20％).The main pathogenic bacteria were Staphylococcus epidermidis(13.60％)and Staphylococcus aureus(11.20％).There were 6 strains of fungi(4.80％),5 strains(4.00％)of Candida alba and 1 strain(0.80％)of Candida tropicalis.The proportion in the infected group of age was ≥ 60 years old,have diabetes,smoking history,chronic obstructive pulmonary disease,operation time ≥3 hours,intraoperative blood loss ≥200 mL,total postoperative thoracic drainage was ≥600 mL,mechanical ventilation time ≥12 hours,the incision was obviously painful,thoracic drainage time ≥5 days,hospital stay ≥20 days were higher than those of the non-infected group(P＜0.05).Age ≥ 60 years old(OR=4.063,95％CI:1.492-11.062),diabetes(OR=2.504,95％CI:1.132-5.539),have a smoking history(OR=1.968,95％CI:1.055-3.670),chronic obstructive pulmonary disease(OR=2.450,95％CI:1.205-4.980),operation time ≥ 3 hours(OR=2.394,95％CI:1.220-4.698),total postoperative thoracic drainage ≥600 mL(OR=3.575,95％CI:1.678-7.618),mechanical ventilation time ≥12 hours(OR=3.059,95％CI:1.330-7.036),hospitalization time ≥ 20 days(OR=2.452,95％CI:1.066-5.641)were high risk factors for postoperative pulmonary infection in patients with lung cancer(P＜0.05).Conclusion The main pathogens of postoperative pulmonary infection in patients with lung cancer were Pseudomonas aeruginosa,Acinetobacter baumannii,Staphylococcus epidermidis,Staphylococcus aureus,Candida alba and Candida tropicalis.Its high risk factors involved age,complications,perioperative indicators and smoking history.
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