Wang Li, Yang Jun, Peng Shi-Yi, Li Guo-Qing, Tu Zi-Wei
Department of Radiotherapy, Eye Ear Nose and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China.
Department of Radiotherapy, Medical College, Nanchang University, Nanchang, PR China.
Cancer Radiother. 2020 Apr;24(2):93-98. doi: 10.1016/j.canrad.2019.09.008. Epub 2020 Feb 11.
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.
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.
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 Candidaalbicans, 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).
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.
放疗后鼻咽坏死（PRNN）是鼻咽癌（NPC）放疗后一种严重的并发症，影响患者预后。临床医生认识到这一问题对于应对这一严峻的临床情况很重要。本研究旨在评估PRNN的细菌学情况，并展示抗菌药敏模式，以指导临床医生更合理地使用抗生素。
回顾性纳入2013年3月至2017年12月在我科就诊的69例患有PRNN的NPC患者。对这69例患有PRNN的NPC患者进行病原菌培养和药敏试验。根据这些结果分析病原菌的感染率和药物敏感性。
本研究纳入了69例患有PRNN的NPC患者。58例（84%）患者鉴定出病原菌。在这58例患者中，34例（58.6%）分离出金黄色葡萄球菌。第二常见的细菌分离菌群是铜绿假单胞菌。抗生素敏感性显示左氧氟沙星最高（88.5%），其次是环丙沙星（85.2%）和庆大霉素（80.3%）。仅有一种病理真菌为白色念珠菌，约占6.8%。PRNN患者的细菌和真菌培养阳性率在患者性别、年龄、分期、放疗疗程数方面无显著差异（P>0.05），但培养阴性患者的治愈率与培养阳性患者相比有统计学意义上的升高（63.6%对20.7%，P=0.011）。
我们的结果提供了患有PRNN的NPC患者的微生物学和药敏模式的总体情况，有助于实施更合理的治疗指南并改善治疗效果。
