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目的观察危重患者导管相关性感染的临床特点、菌群分布及药敏情况。方法分析评定233例导管相关性感染(CRI)患者导管尖端分泌物、导管内血及对侧肢体静脉血培养结果。结果培养出病原菌296株,其中双重感染22例。细菌培养阳性233例,其中革兰阴性杆菌181株,占61%;革兰阳性球菌52株,占18%;真菌63株,占21%。药敏结果显示最常见的革兰阴性杆菌是铜绿假单孢菌,耐药率极高,其中对亚胺培南耐药率为15%;最常见的革兰阳性菌是凝固酶阴性葡萄球菌和金黄色葡萄球菌,对万古霉素敏感率为100%。结论临床对于导管相关性感染应以预防为主,感染发生后有效处理方式是拔除致病导管,根据病原菌培养结果选用敏感抗生素积极抗炎治疗。
Objective To observe the clinical characteristics, distribution and drug sensitivity of catheter-related infections in critically ill patients. Methods Analyze and evaluate the results of catheter tip secretion, intraductal blood and contralateral limb venous blood culture in 233 patients with CRI. Results A total of 296 pathogens were cultivated, of which 22 were double infection. There were 233 cases of bacterial culture positive, of which 181 strains were Gram-negative bacilli, accounting for 61%; 52 strains of Gram-positive cocci, accounting for 18%; 63 fungi, accounting for 21%. Susceptibility results showed that the most common Gram-negative bacilli were Pseudomonas aeruginosa, the rate of resistance was very high, of which resistance rate to imipenem was 15%; the most common gram-positive bacteria were coagulase-negative staphylococcus And Staphylococcus aureus, with a sensitivity of 100% to vancomycin. Conclusions The clinical management of catheter-related infections should be based on prevention. Effective treatment after infection is removal of pathogenic catheters, and positive anti-inflammatory drugs are selected according to the results of pathogen culture.