Laboratory Study On The Influence Of The Flora In The Respiratory Tract Of Patients With Gastric Cancer By Gastrointestinal Decompression

Object: This paper investigated the flora and their drug-resistance in the respiratory tract of patients with gastric cancer and the basic mechanism of production of drug-resistance.Methods: The sputum specimens from 40 patients (11 female patients, 29 male patients from July 2006 to July 2007) of gastric cancer treated without gatric intubation and on day 2, 4 and 6 post gastric intubation after operation were cultivated. The VITEK auto-analysis system was used to identify the types of isolated bacteria and drug-susceptibility strain.Results: Twenty bacteria strains were isolated from 40 patients of gastric cancer without gastric intubation before operation and identified mainly as streptococcus viridans and neisseria sicca. One hundred and twenty-four strains were isolated on day 2, day 4 and day 6 from those patients treated with gastric intubation post-operation. There were fifty-six strains on day 2, forty-five strains on day 4 and twenty-three strain on day 6 isolated respectively. 19.64% isolates were Gram negative bacteria, most of which were Klebsiella pneumoniae. 51.79% isolates were Gram positive bacteria among which streptococcus viridans was predominant. 66.67% Gram negative bacteria were isolated on day 4 after gastric intubation, most of which were Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa. 22.22% Gram positive bacteria were found, among which streptococcus viridans and staphylococcus aureus were predominant. On day 6 treated with gastric intubation, 56.52% Gram negative bacteria was found, most of which were Acinetobacter baumannii and 39.13% Gram positive bacteria found among which staphylococcus epidermidis and staphylococcus aureus were predominant. In those isolates, Gram-negative bacteria were susceptible to Imipenem, Cefperazone- Sulbactam, Aztreonam, Piperacillin sodium and Tazobactam sodium, Ceftazidime Pentahydrate and Ciprofloxacin. Gram positive strain were susceptible to Imipenem , Cefperazone-Sulbactam, Amikacin Sulfate, Ceftazidime Pentahydrate and Ampicillin sodium and Sulbactam sodium. Conclusion: The gastric intubation after operation would cause the variation of flora in respiratory tract in the patients with gastric cancer. The flora varied significantly on more than 4 days after treated with intubation post operation, among which Gram-negative bacteria with multi-drug-resistance were predominant, suggesting the gastric intubation should be taken out as possible as what clinical treatment allowed. It was important to monitor the variation of pathogenic bacteria and their drug-resistance in order to apply susceptible antibiotics and early experimental usage of antibiotics.