ICU呼吸道感染菌药敏与耐药感染危险因素及护理对策分析  

Analysis of Risk Factors and Nursing Countermeasures for Drug-Sensitive and Drug-Resistant Infections of Respiratory Tract Infections in ICUs

作　　者：李珍 LI Zhen(Sanming Integrated Traditional Chinese and Western Medicine Hospital,Sanming 365001,China)

机构地区：[1]三明市中西医结合医院,三明365001

出　　处：《中国医药指南》2024年第16期99-101,共3页Guide of China Medicine

摘　　要：目的 探究ICU呼吸道感染菌药敏与耐药感染危险因素,并分析其护理措施。方法 选取2022年1月至2023年12月我院ICU收治的87例患者,对所有患者进行药敏试验,观察ICU呼吸道感染病原菌及其耐药情况,分析耐药感染的危险因素以及对应护理措施。结果 ICU患者中感染患者21例(4.14%),共检出病原菌198株,以革兰阴性菌中大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌以及革兰阳性菌金黄色葡萄球菌为主。分析主要致病菌药敏情况,革兰阴性菌中大肠埃希菌对头孢唑林钠耐药性最高,肺炎克雷伯菌、鲍曼不动杆菌对阿莫西林/克拉维素具有较高耐药性,同时鲍曼不动杆菌对头孢唑林钠、氨曲南均有较高耐药性。革兰阳性菌中金黄色葡萄球菌主要对替考拉宁、青霉素、头孢唑林钠具有较高耐药性。单因素分析显示,年龄≥60岁、糖尿病、机械通气、入ICU前使用3种以上抗菌药物、入住ICU时长≥2周、APACHE-Ⅱ≥24分增加患者耐药感染风险(P <0.05)。结论 ICU呼吸道感染菌同时存在多株致病菌,风险因素较多,临床护理中需予以重视,严格按要求和规范护理,降低风险。Objective To explore the risk factors of bacterial drug sensitivity and drug-resistant infection of respiratory tract infections in ICU and to analyse their nursing measures.Methods A total of 87 patients admitted to the ICU of our hospital from January 2022 to December 2023 were selected,and drug sensitivity tests were performed on all patients to observe the ICU respiratory tract infection pathogens and their drug-resistant status,and to analyse the risk factors for drug-resistant infections as well as the corresponding nursing measures.Results There were 21 cases(4.14%) of infected patients in ICU,and a total of 198 strains of pathogenic bacteria were detected,with Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,and Staphylococcus aureus,the gram-negative bacteria,as well as the gram-positive bacteria,being the main ones.Analysing the drug sensitivity of the main pathogenic bacteria,Escherichia coli among the gram-negative bacteria had the highest resistance to cefazolin sodium,Klebsiella pneumoniae and Acinetobacter baumannii had high resistance to amoxicillin/clavulanic acid,and at the same time,Acinetobacter baumannii had high resistance to cefazolin sodium and amitrazine.Among the gram-positive bacteria,Staphylococcus aureus was mainly highly resistant to ticlosporin,penicillin,and cefazolin sodium.Univariate analysis showed that age≥60 years,diabetes mellitus,mechanical ventilation,use of more than 3 antimicrobials before admission to the ICU,length of stay in the ICU≥2 weeks,and APACHE-Ⅱ score≥24 increased the risk of drug-resistant infections in the patients(P<0.05).Conclusions ICU respiratory tract infection bacteria at the same time the existence of multiple strains of pathogenic bacteria,more risk factors,clinical care needs to be paid attention to,strictly according to the requirements and norms of care,reduce the risk.

关 键 词：ICU呼吸道感染 感染菌药敏 耐药感染危险因素 护理 

分 类 号：R969.3[医药卫生—药理学] R473.5[医药卫生—药学]