Background: Infections are common complications in patients with non-small cell lung cancer (NSCLC) and may adversely influence clinical outcomes. Their prognostic impact after definitive treatment is not well established. This study aimed to investigate the incidence, microbiological profile, and prognostic significance of infections occurring within one year after definitive treatment in patients with NSCLC. Methods: We retrospectively analyzed patients with NSCLC who completed definitive treatment between 1 January 2016, and 31 December 2023. Microbiological culture results obtained within one-year post-treatment and inflammatory markers measured one month after treatment were evaluated. Pathogens were classified as healthcare-associated infection (HAI) or non-HAI agents. Overall survival (OS) was estimated using the Kaplan–Meier method, and prognostic factors were assessed using Cox regression analysis. Results: Among 214 eligible patients, 45 had positive microbiological cultures. Gram-negative bacteria predominated (n = 24), withPseudomonas aeruginosa(n = 8) andAcinetobacter baumannii(n = 6) being the most frequently isolated species. Among all isolates, 20 Gram-negative and 6 Gram-positive microorganisms were identified as HAI pathogens. In multivariate analysis, culture positivity (HR: 2.75,p< 0.001) remained an independent prognostic factor for worse OS. Conclusion: Infections within the first year after definitive treatment, particularly those caused by HAI-related Gram-negative pathogens, are associated with reduced OS in NSCLC. Early microbiological diagnosis, targeted antimicrobial therapy, and strict infection prevention strategies may help improve outcomes in this high-risk population.
背景：感染是非小细胞肺癌（NSCLC）患者常见的并发症，可能对临床结局产生不利影响。其在根治性治疗后的预后影响尚未明确。本研究旨在探讨NSCLC患者根治性治疗后一年内感染的发生率、微生物学特征及其预后意义。 方法：我们回顾性分析了2016年1月1日至2023年12月31日期间完成根治性治疗的NSCLC患者。评估了治疗后一年内获得的微生物培养结果以及治疗后一个月测量的炎症标志物。病原体被分类为医疗相关感染（HAI）或非HAI病原体。采用Kaplan-Meier法估计总生存期（OS），并使用Cox回归分析评估预后因素。 结果：在214例符合条件的患者中，45例微生物培养呈阳性。革兰氏阴性菌占主导地位（n=24），其中铜绿假单胞菌（n=8）和鲍曼不动杆菌（n=6）是最常分离的菌种。在所有分离株中，20株革兰氏阴性菌和6株革兰氏阳性菌被鉴定为HAI病原体。多变量分析显示，培养阳性（HR: 2.75, p < 0.001）仍然是OS较差的独立预后因素。 结论：根治性治疗后第一年内的感染，特别是由HAI相关革兰氏阴性病原体引起的感染，与NSCLC患者OS降低相关。早期微生物学诊断、针对性抗菌治疗以及严格的感染预防策略可能有助于改善这一高危人群的预后。
Prognostic Impact of Infectious Agents After Definitive Treatment in Non-Small Cell Lung Cancer
肿瘤(癌症)患者之家