无创-有创呼吸机辅助通气患者常见病原体分析  

Analysis of common pathogens in patients with noninvasive-invasive ventilator-assisted ventilation

作　　者：曹莉锋[1] 陈福涛[1] 钟富宽[1] 王彦[1] CAO Li-feng CHEN Fu-tao ZHONG Fu-kuan et al(Lianyungang City Second People＇s Hospital, Lianyungang 222023, Chin)

机构地区：[1]连云港市第二人民医院,222023

出　　处：《中国实用医药》2017年第28期24-26,共3页China Practical Medicine

摘　　要：目的研究无创-有创正压通气患者下呼吸道感染的病原体构成及耐药性。方法 41例给予无创-有创呼吸机辅助通气治疗的患者作为研究对象,采用一次性无菌吸痰管自气管内采集患者痰标本,进行细菌鉴定及药敏实验,观察结果。结果 41例患者进行痰培养143次,分离出菌株69株,阳性率48.25%。分离出的菌株以革兰阴性杆菌为主,主要为铜绿假单胞菌、大肠埃希菌、肺炎克雷伯杆菌、鲍曼不动杆菌,均对亚胺培南的敏感性最高,分别为80.00%、72.72%、77.78%、42.86%,对其他常用药物耐药率较高。白色假丝酵母菌感染率较高,耐药率低。结论接受无创-有创呼吸机辅助通气治疗患者发生革兰阴性杆菌感染者比例高,并且耐药率高,在治疗过程中注意避免交叉感染。根据患者存在的危险因素及疾病严重程度分级,动态检测细菌耐药性,合理选择抗生素。Objective To study the pathogens and drug resistance in patients with noninvasive-invasive ventilator-assisted ventilation. Methods A total of 41 patients with noninvasive-invasive ventilator assisted ventilation were selected as study subjects. The sputum specimens of patients were collected from the trachea by disposable sterile sputum suction tube, and the bacteria identification and drug sensitivity test were carried out to observe the results. Results 41 patients were sputum cultured for 143 times, and 69 strains were isolated, with positive rate as 48.25%. The isolated strains were mainly gram negative bacilli, including Pseudomonasaeruginosa, Escherichia coli, Klebsiella pneumoniae, Acinetobacter Bauman. It had the highest sensitivity to imipenem, respectively as 80%, 72.72%, 77.78% and 42.86%, and had highly resistant to other commonly used drugs. Candida albicans had higher infection rate and low its resistance rate. Conclusion Patients receiving noninvasive-invasive ventilator-assisted ventilation have a high proportion of Gram-negative bacilli infection and resistance rate, and more attention should be payed to avoid cross infection during the course of treatment. A reasonable choice of antibiotics should be made according to the risk factors existed, severity of the disease classification and dynamic detection of bacterial resistance.

关 键 词：呼吸机 辅助通气 下呼吸道感染 无创 有创 

分 类 号：R446.5[医药卫生—诊断学]