神经外科重症监护室医院获得性肺炎细菌培养结果分析及防治对策

目的:探讨神经外科重症监护室医院获得性肺炎的诱发因素、病原菌分布及其耐药性,为疾病的防治提供参考。方法:回顾性分析2003～2005年我科重症监护室73例医院获得性肺炎患者的临床资料,标本均经人工气道直接从深部吸痰取样,应用VITEK2细胞鉴定系统对标本进行鉴定。结果:常见诱发因素为意识障碍、气管插管、气管切开术和机械通气治疗等;最常见病原菌为革兰阴性菌,以铜绿假单胞菌、鲍曼不动杆菌和肺炎克雷伯菌为主;药物敏感试验易出现多重高比例耐药。结论:保持呼吸道通畅,合理使用抗生素,加强全身支持治疗是防治神经外科重症监护室医院获得性肺炎的有效手段。

Clinical Analysis on Culture of Hospital Acquired Pneumonia Bacteria in NICU

OBJECTIVE:To investigate the causative factors,pathogen distribution and drug resistance of hospital acquired pneumonia(HAP) in NICU for reference of its treatment .METHODS:The clinical information of 73 case patients suffering from HAP in NICU in our department from 2003 to 2005 was retrospectively analyzed.All samples were taken from the deep sputum via artificial airway and identified by VITEK2 cell identification system.RESULTS: Factors significantly predisposing HAP were consciousness depression, tracheal intubation or tracheotomy and mechanical ventilation(MV) .Pathogenic bacteria Gram-negatives, mainly Pseudomonas aeruginosa,Acinetobacter baumannii and Klebsiella pneumoiae.were found in most of 73 cases.The drug sensitivity test showed multi -drug resistance.CONCLUSION: Maintaining smooth airway, selecting appropriate antimicrobial and reinforcing therapy of systemic suslainment can effectively prevent HAP in NICU.