急诊开颅术后患者发生肺部感染的病原菌种类及易感因素分析  

Analysis of 256 cases of pulmonary infections after emergency craniotomy:Pathogen species and predisposing factors

作　　者：路春雨[1] 王斌[1] 吴义天[1] 吴晓东[1] 

机构地区：[1]安徽省淮北市人民医院脑外科,安徽淮北235000

出　　处：《中国病原生物学杂志》2016年第10期931-936,共6页Journal of Pathogen Biology

摘　　要：目的总结并探讨急诊开颅术后肺部感染致病菌分布及耐药性,分析其致病因素,为临床治疗提供依据。方法本院2008年7月-2016年3月共急诊开颅1098台次,其中术后发生肺部感染的患者共256例,回顾性研究所有256例术后发生肺部感染的患者资料,对肺部感染的致病菌、耐药性及易感因素进行统计学分析。结果所有256例患者共培养出致病菌株326株,其中革兰阴性菌236株,占72.39%;革兰阳性菌57株,占17.48%;真菌33株,占10.12%。鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、白色假丝酵母菌和表皮葡萄球菌分别占29.75%、9.51%、9.20%、8.28%、6.75%和8.28%。结论鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、白色假丝酵母菌和表皮葡萄球菌是急诊开颅术后发生肺部感染最常见细菌,尤其是鲍曼不动杆菌为多发且耐药性严重;术后转入ICU并行呼吸机辅助呼吸的肺部感染患者发生率较高且易于产生耐药菌株。Objectives To summarize the pathogens causing pulmonary infections after emergency craniotomy and the drug resistance of those pathogens and to analyze predisposing factors. Methods Clinical data on 256 patients in Neurosurgery who developed a pulmonary infection from July 2008 to March 2016 were retrospectively examined.Pathogens,their drug resistance,and predisposing factors were statistically analyzed. Results Three hundred and twenty-six strains of pathogens were detected in 256 specimens.Of those strains,236（72.39%）were Gram-negative bacteria,57（17.48%）were Gram-positive bacteria,and 33（10.12%）were fungi.Acinetobacter baumannii accounted for 29.75% of the strains,Pseudomonas aeruginosa accounted for 9.51%,Klebsiella pneumoniae accounted for 9.20%,Escherichia coli accounted for 8.28%,Candida albicans accounted for 6.75%,and Staphylococcus epidermidis accounted for 8.28%. Conclusion A.baumannii,P.aeruginosa,K.pneumoniae,E.coli,C.albicans and S.epidermidis are all pathogens that caused a pulmonary infection after emergency craniotomy,but A.baumannii was the most prevalent pathogen and the bacterium was highly drug-resistant.After transfer to the ICU and while on a ventilator,patients were apt to suffer a higher rate of infection by a drug-resistant pathogen.

关 键 词：急诊开颅术 肺部感染 病原菌 耐药性 易感因素 

分 类 号：R378[医药卫生—病原生物学]