颅脑创伤气管切开后呼吸道感染病原菌分布调查分析  

Analysis of distribution of pathogens causing respiratory tract infections after traumatic brain injury after tracheotomy

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室,河南卫辉453100

出　　处：《中华医院感染学杂志》2012年第6期1290-1292,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨颅脑创伤患者行气管切开后呼吸道感染病原菌的分布情况。方法选取于住院治疗的颅脑创伤患者60例,所有患者均行气管切开术,取患者痰标本行痰培养检查,对其痰培养结果进行回顾性分析。结果 60例痰标本中阳性45例,阳性率为75.0%;共培养病原菌83株,其中革兰阴性菌61株占73.5%,分别为乙酸钙鲍氏不动杆菌21株占25.3%、铜绿假单胞菌15株占18.1%、肺炎克雷伯菌13株占15.7%、大肠埃希菌8株占9.6%、嗜麦芽寡养单胞菌4株占4.8%;革兰阳性菌18株占21.7%,分别为金黄色葡萄球菌9株占10.8%、表皮葡萄球菌5株占6.0%、溶血性链球菌3株占3.6%、肠球菌属1株占1.2%;真菌4株占4.8%,分别为白色假丝酵母菌3株占3.6%、曲霉菌属1株占1.2%。结论颅脑创伤患者行气管切开后,呼吸道感染病原菌主要有革兰阴性菌、革兰阳性菌及真菌;对呼吸道感染凭早发现、早治疗的原则,合理应用敏感抗菌药物,可有效降低颅脑创伤患者行气管切开后呼吸道感染的死亡率。OBJECTIVE To investigate the distribution of pathogens for respiratory tract infections after traumatic brain injury after tracheotomy.METHODS A total of 60 patients underwent tracheotomy due to traumatic brain injury in our hospital were chosen.After sputum culture examination of sputum specimens,their sputum culture results were analyzed retrospectively.RESULTS Positive results were obtained in 45 cases of 60 cases of sputum specimens,with the positive rate of 75.0%.There were totally 83 pathogens cultured,including 61 gram-negative strains,accounting for 73.5%,consisted of 21 strains of calcium acetate Acinetobacter baumannii（25.3%）,15 strains of Pseudomonas aeruginosa（18.1%）,13 strains of Klebsiella coli（15.7%）,8 strains of Escherichia coli（9.6%）,4 strains of Stenotrophomonas maltophilia（4.8%）.18 Gram-positive bacteria were found,accounting for 21.7%,including 9 strains of gold Staphylococcus aureus（10.8%）,5 strains of S.epidermidis（6.0%）,3 strains of hemolytic Streptococcus（3.6%）,and 1 strain of Enterococci（1.2%）.CONCLUSION The main pathogens for respiratory tract infections are gram-negative bacteria,gram-positive bacteria and fungi in patients with traumatic brain injury after tracheotomy.For respiratory tract infections,holding the principles of early detection and early treatment,and making rational use of antibiotics can effectively reduce the mortality rate of respiratory infections for patients with brain injury undergoing tracheotomy.

关 键 词：颅脑创伤 气管切开 呼吸道感染 病原菌 分布 

分 类 号：R378[医药卫生—病原生物学]