RICU有创通气患者下呼吸道感染病原菌研究  

Research of pathogens at lower respiratory tract of patients with mechanical ventilation in RICU

作　　者：阎锡新[1] 王海宾[2] 吴亚丽[1] 王保法[1] 

机构地区：[1]河北医科大学第二医院呼吸内科,石家庄050000 [2]石家庄市结核病防治所,050091

出　　处：《国外医学（呼吸系统分册）》2005年第1期9-11,共3页Section of Respiratory System Foreign Medical Sciences

摘　　要：目的　研究呼吸重症监护病房 (RICU)内有创机械通气患者 4 8小时后下呼吸道致病菌的细菌学情况。方法　对RICU内的 5 5例有创机械通气患者分别于上机后 4 8小时、5～ 7天、14天或拔管前采集下呼吸道分泌物作细菌培养、药敏及定量分析 ,细菌学资料作统计学分析。结果　采集下呼吸道分泌物12 9例次 ,86次细菌培养阳性 ,分离细菌 112株 ,以G-杆菌为主 ,占 91.0 7%。G-杆菌以铜绿假单胞菌(39.2 8% ) ,鲍曼不动杆菌 (2 3.2 1% )和大肠埃希菌 (7.14 % )为主。这些细菌具有多耐药性和较高的耐药率。结论　RICU患者下呼吸道感染菌随病程进展变化较大 ,特别是机械通气 4 8小时后 ,常以铜绿假单胞菌、鲍曼不动杆菌和大肠埃希菌为主 ,应经常监测病原微生物学 ,指导抗生素正确使用 ,减少下呼吸道院内感染 ,降低死亡率。Objective To study the bacteriological data of pathogens at lower respiratory tract of patients with mechanical ventilation(MV) in the respiratory intensive care unit(RICU) at different time.Methods The 129 samples were collected from 55 patients with MV admitted in RICU at 48 hours,5th or 7th day and 14th day after MV.Bacterial culture,drug-sensitive test and quantitative analysis were done,and the data were analyzed statistically.Results The 112 lines of pathogens were separated from 86 of the 129 samples.The chief pathogens were Gram-negative bacilli,accounted for 91.07% ,with Pseudomonas aeruginosa ( 39.28% ),Acinetobacter baumannii( 23.21% )and Escherichia coli ( 7.14% ) as the major contributors.These pathogens possess multi-drug resistance and higher antibiotic resistance rate.Conclusions The patient in RICU,especially those with MV longer than 48 hours can be affected by bacteriological pathogens.It is necessary to monitor the species of these pathogens in order to guide the correct use of antibiotics,and to prevent infection of lower respiratory trcact and to reduce the mortality rate.

关 键 词：RICU 有创通气 下呼吸道感染 病原菌 

分 类 号：R56[医药卫生—呼吸系统]