重症监护病房非发酵菌致下呼吸道感染的危险因素和耐药性分析

目的：探讨我院ICU非发酵菌致下呼吸道感染的危险因素及其耐药性的分布情况。方法：对150例非发酵菌致下呼吸道感染的临床资料和细菌学药敏试验结果做回顾性分析。结果：150例患者细菌培养出主要非发酵菌为铜绿假单胞菌89株，鲍曼氏不动杆菌36株，脑膜脓毒金黄杆菌57株，嗜麦芽假单胞菌31株，洋葱假单孢菌55株，产吲哚黄杆菌20株。耐药率较高。150例中60岁以上者93例(62％)，全部病例均有基础疾病。84％病例为混合感染。发病的危险因素为：广谱抗菌药物的应用、机体的免疫抑制和侵袭性治疗。结论：非发酵菌致下呼吸道感染多发生于患有各种基础疾病、免疫功能低下及长期应用广谱抗菌药物者，细菌的耐药现象严重，应根据病原学检查和药敏试验结果选择敏感的抗生素。

Analysis of the Risk Factors and Drug Resistance of Lower Respiratory Tract Infection Caused by Non-fermentive Bacteria in ICU

Objective:To investigate risk factors of 150 cases with lower respiratory tract infection caused by non-fermentive bacteria and its antimicrobial susceptibility in vitro. Methods:The clinical data of 150 cases of lower respiratory tract infection caused by non-fermentive bacteria and drug susceptibility were analyzed. Results:The most common pathogens were pseudomonas aeruginesa(89 strains), acinetobacter baumanni(36 strains),chryseobacterium meningose(57 strains),stenotrophomenas maltophilia(31 strains), Burkholdena cepacia(55 strains), chryseobacterium indologen(20 strains). Isolates were highly resistant to most of antimicrobial agents. All of the cases suffered from underlying diseases.84% of the cases were mixed infection. Risk factors of infections were application of multiple antibiotics, host immune suppression and invasive manasements. Conclusions:The lower respiratory tract infection caused by non-fermentive bacteria developed most commonly in patients who suffered from various underlying diseases, immunodeficiency and longtime antibiotic overuse Because the clinical isolates were highly to most kinds of antimicrobial agents, the antibiotics should de chosen according to the result of the antimicrobial susceptibility test.