脑血肿患者气管切开后肺部感染的病原菌分布与药敏监测  

Distribution and drug resistance monitoring of pathogens for pulmonary infections after tracheotomy in patients with intracerebral hematoma

作　　者：郭舜源[1] 陈波[1] 耿昱[1] 

机构地区：[1]浙江省人民医院神经内科,浙江杭州310014

出　　处：《中华医院感染学杂志》2014年第16期3928-3930,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅基金资助项目(2013KYB032)

摘　　要：目的探讨高血压脑血肿患者气管切开后肺部感染的病原菌分布及耐药性,以便更好的治疗该疾病。方法选取2010年4月-2013年2月88例高血压脑血肿行气管切开肺部感染患者为研究对象,对发生肺部感染的患者进行病原菌和耐药性分析,采用SPSS13.0软件进行统计。结果 88例气管切开肺部感染患者分离出病原菌101株,其中革兰阴性菌51株占50.50%,革兰阳性菌37株占36.63%,真菌13株占12.87%;主要革兰阴性菌对亚胺培南、头孢哌酮/舒巴坦、头孢曲松的耐药较低,<25.00%;革兰阳性菌对万古霉素、左氧氟沙星耐药较低,在<10.00%;真菌对两性酶素B、咪康唑、益康唑耐药较低,<20.00%。结论对高血压脑血肿气管切开肺部感染患者,要根据药敏试验结果选择敏感抗菌药物。OBJECTIVE To investigate distribution and drug resistance of pathogens for pulmonary infections after tracheotomy in patients with hypertensive intracerebral hematoma,so as to facilitate better treatments for the disease.METHODS Totally 88 patients with hypertensive intracerebral hematoma who developed pulmonary infections after tracheostomy during Apr.2010-Feb.2013 were selected as the research subjects in this study,analysis of pathogens and drug resistance was conducted for patients who experienced pulmonary infections according to infection criteria.Data were analyzed with SPSS 13.0.RESULTS Totally 101 pathogens were isolated from the 88 patients,including 51 strains of gram-negative bacteria（50.5%）,37 strains of gram-positive bacteria（36.63%）,13 strains of fungi（12.87%）.The drug resistance of the main gram-negative bacteria was low（25.00%）to imipenem,cefoperazone/sulbactam,and ceftriaxone;the drug resistance of gram-positive bacteria was low（10.00%）to vancomycin and levofloxacin;the drug resistance of fungi was low（20.00%）to amphotericin B,miconazole,and econazole.CONCLUSION Sensitive antibiotics for pulmonary infections after tracheotomy in patients with hypertensive intracerebral hematoma should be chosen based on the susceptibility test results.

关 键 词：脑血肿 气管切开 肺部感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]