ICU中建立人工气道后呼吸道获得性感染的临床分析  

Clinical Analysis of Hospital Acquired Respiratory Tact Infection in the Patients with Artifical Airway

作　　者：韩伯南[1] 李哲[1] 

机构地区：[1]浙江省余姚市人民医院,浙江余姚315400

出　　处：《河北医学》2001年第1期28-30,共3页Hebei Medicine

摘　　要：目的 :研究 ICU中建立人工气道患者呼吸道获得性感染的发生率、致病菌、药敏和耐药情况。方法 :分析 1998年 1月至 1999年 3月间 ,收住本院 ICU中建立人工气道患者的呼吸道分泌物的常规培养和药敏资料。结果 :36例 4 3次呼吸道分泌物培养阳性 35次 ,阳性率 81.4 %。其中细菌 30株 ,占 85.7% ,共 14个菌种 ;霉菌 5株 ,占 14.3% ,共 2个菌种 ,均为真菌。细菌和真菌混合感染 5例 ,达 14.3%。革蓝氏阴性杆菌 (G)主要为铜绿假单胞菌 (2 8.6 % )、鲍曼氏不动杆菌 (11.4 % )、阴沟杆菌(8.6 % )。革蓝氏阳性球菌 (G)主要为表皮葡萄球菌 (11.4 % )、溶血性葡萄球菌 (2 .9% )。药敏结果为 :对青霉素类、氟喹诺酮类、氨基苷类、头孢三代耐药 G杆菌分别达 75%、4 2 .1%、4 0 .4 %、2 6 .1% ,G球菌分别达 50 %、36 .2 %、2 2 .5%、15.7%。结论 :ICU中建立人工气道患者的呼吸道获得性感染的控制是危重病抢救过程中一个及其重要的环节。由于广谱抗生素的广泛应用 ,耐药菌株和二重感染日益增多 ,应用适当抗生素预防和治疗 。Objective:[WT5BZ][ST5BZ]In order to investigate the incidence of hospital acquired respiratory tract infection in the patients with artifical airway in ICU and study the species of pathogenic organism and bacterial drug resistant spectrum and bacterial drug resistant spectrum.[WT5HZ]Methods: [WT5BZ]The results drug susceptibility tests in patients with artifical airway from Jan,1998 to Mar.1999 were analyzed,retrospectively.[WT5HZ]Results: [WT5BZ]of 43 cultures in 36 patients,the positive rate is 81.4%,30 strains of bacteria 85.7% and 5 strains of fungus(14.3%)were found in cultures.There were 14 species of bacteria and 2 species of fungs in infection patients.5 cases of patients(14.3%)had mixed infection.The predominant species of Gram( )bacilli were PS.aeruginos(28.6%).Acinetobacter baumanii(11.4%)and Enterobacter cloacae (8.6%).The species of Gram(+)cocci were S.epideridis(11.4%)and Staphylococcus hemolysis(2.9%).The resistance rate of Gram( )bacilli to Penicillin,Quinolone,Amikacini and the third generation Cephalosporins were 75%,42.1%,44.4%and 26.1%,respectively.[WT5HZ]Conclusion[WT5BZ] Hospital acquired respirator tract infection control plays a key role in the treatment of critically ill patients with artifical airway.Multi drug resist and bacteria and mixed infection are very common.We must pay more attention to the monitory of acquired infection and using antibiotics reasonable. [WT5HZ]

关 键 词：ICU 人工气道 呼吸道获得性感染 抗生素 耐药性 

分 类 号：R446.5[医药卫生—诊断学]