Distribution and Risk Factors of Hospital Acquired Pathogens in Patients with Esophageal Cancer Undergoing Radiotherapy and Chemotherapy

GUO Jing; XIAO Yinhua; MA Yinghui

doi:10.3969/j.issn.1004-437X.2025.06.019

Abstract：Objective To explore the pathogen distribution and risk factors of nosocomial infection in 86 cases with esophageal cancer treated with radiotherapy and chemotherapy.Methods A total of 86 cases with nosocomial infection of esophageal cancer treated in our hospital from January 2019 to January 2023 were selected as the infection group,and 95 patients without nosocomial infection who received radiotherapy and chemotherapy in our hospital during the same period were selected as the control group.Blood,sputum,urine of patients with nosocomial infection of esophageal cancer were collected for bacterial culture and identification,and the detection and distribution of pathogenic bacteria were analyzed.Then multivariate logistic regression was used to analyze the risk factors of nosocomial infection.Results A total of 97 strains were isolated from 86 patients with nosocomial infection of esophageal cancer,the main strains were 60 gram-negative bacteria(61.86％),followed by 27 gram-positive bacteria(27.83％)and 10 fungi(10.31％).Among gram-negative bacteria,there were 28 strains of Pseudomonas aeruginosa(28.89％),followed by 19 strains of Klebsiella pneumoniae(17.53％),17 strains of Staphylococcus aureus(24.94％),and 7 strains of Candida albus(7.21％).In this study,lung infection was the most common infection site in 86 patients with nosocomial infection of esophageal cancer,accounting for 65.12％.Univariate analysis showed that tumor stage,tumor location,radiotherapy time,radiotherapy dose,nutritional status,prophylactic use of antibiotics,neutrophil count and albumin were related to the incidence of nosocomial infection in cases with esophageal cancer(P＜0.05).Duration of radiotherapy[OR(95％CI):3.387(1.926-5.956)],nutritional status[OR(95％CI):2.705(1.686-4.338)],tumor stage[OR(95％CI):2.106(1.385-3.204)],prophylactic use of antibiotics[OR(95％CI):3.781(2.027-7.052)]and neutrophil count[OR(95％CI):2.863(1.697-4.832)]were the risk factors for nosocomial infection in cases with radiotherapy and chemotherapy for esophageal cancer(P＜0.05).Conclusion The main pathogens of nosocomial infection in patients with esophageal cancer were gram-negative bacteria,and the infection occurred mostly in lung,and the occurrence of nosocomial infection was affected by multiple factors.