ICU气管切开患者肺部感染病原菌分布及耐药性分析  

Drug resistance analysis and distribution of pathogenic bacteria causing lung infections in tracheotomy patients in ICU

作　　者：曾萍[1] 杨荣霞[1] 程明琨[1] 牛珊珊[1] 王丽丽[1] 

机构地区：[1]新乡医学院第一附属医院重症监护病房,河南卫辉453100

出　　处：《中华医院感染学杂志》2012年第5期1069-1071,共3页Chinese Journal of Nosocomiology

摘　　要：目的分析重症监护病房(ICU)气管切开患者肺部感染病原菌分布及耐药性特点,为预防和治疗肺部感染提供参考资料。方法选取医院ICU的患者258例,所有患者均行气管切开术,术后取患者痰标本进行细菌培养,对培养结果进行统计分析。结果痰培养阳性86例,感染率为33.3%;共分离出104株病原菌,其中革兰阴性菌81株,占77.9%,主要为鲍氏不动杆菌28株、铜绿假单胞菌17株、肺炎克雷伯菌16株;革兰阳性菌19株占18.3%,主要为金黄色葡萄球菌9株;真菌4株占3.9%;鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌对临床常用抗菌药物耐药性均较高。结论 ICU气管切开患者肺部感染病原菌主要包括革兰阴性菌、革兰阳性菌及真菌,其中革兰阴性菌最为常见;对肺部感染患者要及时诊断并合理选择抗菌药物进行有效治疗,从而提高临床疗效,降低患者死亡率。OBJECTIVE To analyze the pathogen distribution and drug resistance characteristics of lung infection for tracheotomy patients in intensive care unit so as to provide reference for the prevention and treatment of lung infections.METHODS A total of 258 patients who underwent tracheotomy treated in ICU of our hospital were chosen.Culture examination of sputum specimens was performed after treatment.The sputum culture results for all patients were taken for statistical analysis.RESULTS The results showed that 86 cases were positive,the infection rate was 33.3%.Gram-negative pathogens were found in 81 cases,accounting for 77.9%.There were mainly 28 strains of Acinetobacter baumannii,17 strains of Pseudomonas aeruginosa,16 strecins of Klebsiella pneumoniae.Gram-positive bacteria were found in 19 cases,accounting for 18.3%,there were mainly 9 Staphylococcus aureus.Fungi were detected in 4 cases,accounting for 3.9%.The drug strains of resistance of A.baumannii,P.aeruginosa,K.pneumoniae and Escherichia coli to the commonly used antibiotics were all high.CONCLUSION The lung infection pathogens in intensive care patients with tracheotomy mainly include gram-negative bacteria,gram-positive bacteria and fungi,of which the most common are gram-negative bacteria.Timely diagnosis and reasonable use of antibiotics for patients with lung infection are crucial for improving the clinical efficacy and reducing the mortality.

关 键 词：重症监护病房 气管切开 肺部感染 

分 类 号：R378[医药卫生—病原生物学]