Analysis On Risk Factors And Pathogens In Patients With Pulmonary Infection After The Operation Of Esophageal Cancer And Investigate Its Prevention

Objective: To investigate the related risk factors of pulmonary infection in patients after the operation for esophageal cancer, together with the distribution of the pathogens and the pathogens’ resistance to common antibacterial agents, and propose the corresponding preventive and therapeutic methods. Methods: Retrospective analysis was used to study the data about age, smoking history, pulmonary function before surgery, DM, heart disease, COPD, operation duration, intraoperative blood loss, operation method, pathological staging, pathogens and the pathogens’ resistance to common antibacterial agents in483patients who have a surgery for esophageal cancer in the department of thoracic in the first affiliated hospital of Fujian Medical University from Jan2011to Dec2013.The data was processed by the software SPSS19.0.Results：(1) Single related factors analysis showed that the follow6factors have different Statistically significant in patients with or without pulmonary infection: elder, DM, COPD, long history of heavy smoking, long time of surgery, operation method（P<0.05）. Multiple related factors analysis showed that t the follow5factors maybe the independent risk factors: elder, DM, COPD, long history of heavy smoking, long time of surgery（OR>1，P<0.05）.(2)43.5%of the bacterial pathogens were the Gram-negative bacteria which mainly consist of pneumonia after esophagectomy for cancer.41.9%of the pathogens were fungus which ranked second. The rest14.5%was caused by Gram-positive bacteria. For staphylococcus aureus, penicillin kind of antibacterial drug have a high resistant rate, but it is highly sensitive to quinolone and vancomycin. For Peudomonas aeruginosa, most of the antimicrobial drugs have a lower resistant level, it is highly sensitive to carbapenems, quinolone and aminoglycoside. β-lactam antimicrobial drugs have a high resistant rate to Klebsiella pneumonia which is highly sensitive toβ-lactam class/β-lactamase inhibitor drugs. Acinetobacter baumannii is almost resistant for all kinds of antimicrobials. For fungus, Candida albicans and Nearly smooth candida were highly sensitive to most of the Antifungal drugs. While Smooth candida is moderately sensitivity to fluconazole and itraconazole.Conclusion：(1) Pulmonary infection after surgery for esophageal cancer may be related to elder, DM, COPD, long history of heavy smoking, long time of surgery, making effective preventive methods for the related risk factors may reduce the incidence of pulmonary infection.(2) Gram-negative bacteria mainly consist of the bacterial pathogens for pulmonary infection after surgery for esophageal cancer. The second is fungal infections and Gram-positive bacteria is the least. More attentions should be paid to the pathogenic species, and during the clinical work, we should chose antibiotics that against Gram-negative bacteria for pulmonary infection after surgery. Antibiotics should be changed according to the results of drug sensitivity tests if them didn’t work.