摘要
目的探讨重症监护病房(ICU)患者气管切开后肺部感染病原菌的类型及其耐药性,为临床经验性用药提供帮助。方法回顾性分析ICU 68例气管切开术后并发肺部感染患者的痰细菌培养及药物敏感性测定结果。结果共分离出97株致病菌,其中革兰阴性杆菌(GNB)占67.01%,革兰阳性球菌(GPC)占27.84%,真菌占5.15%。铜绿假单胞菌居首位,分离出产超广谱β-内酰胺酶(ESBLs)菌6株,耐甲氧西林金黄色葡萄球菌(MRSA)5株。所分离致病菌对常用抗菌药物均有不同程度的耐药,且为多重耐药。气管切开患者肺部感染与基础疾病、使用呼吸机、昏迷、不合理应用抗菌药物密切相关。结论ICU气管切开患者肺部感染是多因素相互作用的结果,致病菌以GNB为主,临床应重视病原菌的检查及耐药性的监测,合理选用抗菌药物。
Objective To investigate the distribution and drug resistance of pathogen from ICU patients with lung infections following tracheal incision. Methods 68 in - patients were complicated with lung infections following tracheal incisions and a retrospective analysis of the cultured pathogenic microorganisms from the sputum and their susceptibility to drugs was thus performed. Qualified sputum specimens were cultured for bacterial isolation, and the anti - microbial activity tests were determined. Results Totally 97 strains of pathogens were isolated by bacterial culture, of which the Gram - negative bacilli （GNB） isolated was 67.01% in proportion, the Gram - positive cocci （GPC） was 27.84% and the fungi was 5.15% , respectively. Among them the Pseudomonas aeruginosa contributed to the majority, those producing the extended - spectrum 13 - lactamases （ESBLs） accounted for 6 strains, and methicillin - resistant staphylococcusaureus （MRSA） contributed to 5 strains. They were resistant to common antibiotics and particularly resistant to a multitude of antibiotics. Lower respiratory infections following tracheal incision were closely correlated with basic diseases, use of ventilator, duration of coma and abuse of antibiotics. Conclusions The lung infections in patients with tracheal incision in ICU were caused by the interactions of multiple factors. The major pathogenic microorganisms are GNB. It is advisable that emphasis be laid on the surveillance of bacterial resistance and rational use of antimicrobial agents in clinical therapy.
出处
《徐州医学院学报》
CAS
2008年第11期715-718,共4页
Acta Academiae Medicinae Xuzhou
关键词
肺部感染
气管切开
病原菌
重症监护病房
lung infections
tracheal incision
pathogenic microorganism
intensive care unit
