气管切开术后长期置管高龄患者的下呼吸道细菌定植情况  

Situation of lower respiratory tract bacterial colonization in senile patients with long-term catheterization after tracheotomy

作　　者：黄冬薇 蔡学究 张德明 胡亚惠 王雪妮 HUANG Dong-wei;CAI Xue-jiu;ZHANG De-ming;HU Ya-hui;WANG Xue-ni(The Third Department of Geriatrics,General Hospital of Southern Theatre Command of Chinese People's Liberation Army,Guangzhou 510010,Guangdong,China)

机构地区：[1]中国人民解放军南部战区总医院老年三科,广东省广州市510010

出　　处：《广西医学》2022年第13期1479-1482,1495,共5页Guangxi Medical Journal

基　　金：国家重点研发计划(2020YFC2008900);广东省医学科学技术研究基金(A2018446)。

摘　　要：目的 探讨气管切开术后长期置管高龄患者的下呼吸道细菌定植情况。方法 选择处于非感染期的气管切开术后长期置管的164例高龄患者,收集其痰标本(共319份)进行细菌培养及药敏测定。分析患者下呼吸道定植菌培养阳性率(细菌定植率)、菌种构成、耐药率,并比较不同置管时长患者的细菌定植率。结果 255份痰标本定植菌培养结果为阳性,细菌定植率为79.9%(255/319)。共培养出定植菌268株,其中革兰阴性菌占71.3%(191/268),以铜绿假单胞菌最为常见;革兰阳性菌占14.2%(38/268),真菌占14.6%(39/268)。定植菌对各类抗菌药物均产生不同程度的耐药。不同置管时长患者的细菌定植率差异无统计学意义(P>0.05)。结论 气管切开术后长期置管的高龄患者下呼道细菌定植率高,革兰阴性菌为主要定植菌,但细菌定植率与置管时长无明显关系。定植菌对各类抗菌药物均产生不同程度的耐药。Objective To explore the situation of lower respiratory tract bacterial colonization in senile patients with long-term catheterization after tracheotomy.Methods A total of 164 senile patients with long-term catheterization after tracheotomy during non-infection period were selected,and the sputum specimens(319 sputum specimens in total)were collected for bacterial culture and susceptibility test.The culture positive rate(bacterial colonization rate),bacterial strain composition,and drug resistance rate of patients′lower respiratory tract colonized bacteria were analyzed,and the bacterial colonization rate was compared between the patients with different length of catheterization time.Results The culture results of colonized bacteria in 255 sputum specimens were positive,and the bacterial colonization rate was 79.9%(255/319).A total of 268 strains of colonized bacteria were cultured,among which Gram-negative bacteria accounted for 71.3%(191/268),and Pseudomonas aeruginosa was the most common.Gram-positive bacteria accounted for 14.2%(38/268),and fungus accounted for 14.6%(39/268).The colonized bacteria had different degrees of drug resistance to various kinds of antimicrobial.No statistically significant difference was found in the bacterial colonization rate between the patients with different length of catheterization time(P>0.05).Conclusion The bacterial colonization rate in lower respiratory tract is high in the senile patients with long-term catheterization after tracheotomy.The Gram-negative bacteria are the main colonized bacteria;however,there is no significant relation of the bacterial colonization rate with the length of catheterization time.The colonized bacteria depict different degrees of drug resistance to various kinds of antimicrobial.

关 键 词：细菌定植 下呼吸道 气管切开术 耐药性 高龄 长期置管 

分 类 号：R378[医药卫生—病原生物学]