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目的了解重症监护病房气管切开患者下呼吸道定植菌分布和耐药性情况。方法通过对病人标本细菌分离培养和鉴定方法,对某医院重症监护病房2008年10月-2011年6月实施气管切开的180例患者下呼吸道标本进行了细菌检测和药敏试验。结果在180例气管切开患者的下呼吸道标本中,检出有定植菌153份,检出率为85%。共分离出定植菌232株,以革兰阴性菌为主,占78.8%,其中铜绿假单胞菌62株,居首位,占26.7%;其次为肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希菌等。革兰阳性菌占14.7%,真菌占6.5%。药敏试验结果显示,革兰阴性菌均出现较强的耐药性。结论重症监护病房实施气管切开患者下呼吸道细菌定植严重,成为呼吸道感染的重要因素,应重点加强防控。
Objective To understand the distribution and drug resistance of lower respiratory tract bacteria in tracheotomy patients in intensive care unit. Methods The bacterial specimens and antibiotic susceptibility tests of 180 patients with tracheotomy were performed on the lower respiratory tract specimens from a hospital intensive care unit from October 2008 to June 2011. Results In the lower respiratory tract specimens of 180 tracheotomy patients, 153 colonized bacteria were detected, the detection rate was 85%. 232 strains of bacteria were isolated, mainly Gram-negative bacteria, accounting for 78.8%, of which 62 strains of Pseudomonas aeruginosa, ranking first, accounting for 26.7%; followed by Klebsiella pneumoniae, Acinetobacter baumannii , Escherichia coli and so on. Gram-positive bacteria accounted for 14.7%, fungi accounted for 6.5%. Susceptibility test results show that Gram-negative bacteria showed strong resistance. Conclusion The tracheotomy patients in intensive care unit have severe lower respiratory tract colonization and become an important factor in respiratory tract infection. Prevention and control should be emphasized.