Department of Pharmaceutical Microbiology, Medical University of Lublin, Lublin, Poland.
Med Sci Monit. 2010 Feb;16(2):CR84-91.
Microbial colonization of pleural drains during the postoperative period may be regarded as an important factor in infection development. The aim of this paper was to determine the frequency and risk factors associated with microbial colonization of pleural drains in patients with non-small-cell lung cancer (NSCLC) who underwent surgical resection.
MATERIAL/METHODS: A total of 72 pleural drain fluids obtained from 36 patients with NSCLC were microbiologically examined.
Microbial colonization of pleural drain fluid was noted in 30/36 patients (83.34%). Aerobic and anaerobic bacteria were found in 13 (36.11%) and 7 (19.44%) patients, respectively, and mixed microflora were cultured from 9 (25%). Non-fermentative gram-negative rods and coagulase-negative staphylococci were mainly isolated. Univariate analysis revealed that FEV1% >65 and FEV1/FVC were significantly related to drain colonization by bacteria in general, FEV1/FVC to colonization by aerobic bacteria, and hospitalization >5 days before surgery to colonization by anaerobic bacteria. According to multivariate analysis, application of antibiotic prophylaxis other than cefuroxime or ceftriaxone and FEV1% >65 were the independent factors related to drain colonization by bacteria in general; antibiotic prophylaxis other than cefuroxime or ceftraixone alone and hospitalization >5 days before surgery to colonization by anaerobic bacteria; and a higher rate of FEV1/FVC, no chemotherapy before surgery, and postsurgical complications after surgery to colonization by aerobic bacteria.
Patients with resectable lung cancer showed a high rate of pleural drain colonization, mainly by opportunistic pathogens, even in the absence of clinical signs of infection.
术后胸腔引流管的微生物定植可能被认为是感染发展的一个重要因素。本文旨在确定行手术切除的非小细胞肺癌（NSCLC）患者胸腔引流管微生物定植的频率和相关危险因素。
材料/方法：对 36 例 NSCLC 患者的 72 份胸腔引流液进行了微生物学检查。
36 例患者中有 30 例（83.34%）胸腔引流液发生微生物定植。13 例（36.11%）和 7 例（19.44%）患者分别培养出需氧菌和厌氧菌，9 例（25%）培养出混合菌群。主要分离出非发酵革兰阴性杆菌和凝固酶阴性葡萄球菌。单因素分析显示，FEV1% >65 和 FEV1/FVC 与细菌定植总体显著相关，FEV1/FVC 与需氧菌定植相关，住院>5 天与厌氧菌定植相关。多因素分析显示，应用除头孢呋辛或头孢曲松以外的抗生素预防和 FEV1% >65 是与细菌定植总体相关的独立因素；应用除头孢呋辛或头孢曲松以外的抗生素预防和住院>5 天与厌氧菌定植相关；FEV1/FVC 较高、术前无化疗和术后出现术后并发症与需氧菌定植相关。
可切除肺癌患者胸腔引流管定植率较高，主要为机会致病菌定植，即使无感染临床症状。
