9例大面积烧伤合并吸入性气道损伤患者下呼吸道感染的预防与控制

目的：探讨9例大面积烧伤合并吸入性气道损伤患者下呼吸道感染的预防与控制措施。方法调查9例大面积烧伤合并吸入性损伤患者的下呼吸道分泌物培养的病原菌细菌谱及耐药情况。结果共检出下呼吸道病原菌2种，共38株，其中鲍曼不动杆菌37株，占97．36％（37／38）；嗜麦芽假单胞菌1株，占2．64％（1／38）。鲍曼不动杆菌耐药率达到75．59％，对替加环素、米诺环素敏感性90％以上。经过严格实施感染预防与控制，合理使用抗菌药物等综合措施后取得了良好的疗效，鲍曼不动杆菌检出率明显下降。结论本文患者的下呼吸道病原菌以鲍曼不动杆菌最常见，虽然鲍曼不动杆菌感染率及耐药率高，但可以通过有效的消毒隔离、严格的下呼吸道医院感染预防措施及合理应用抗菌药物等方法，使鲍曼不动杆菌的检出率明显下降。

The prevention and control of lower respiratory tract infection in 9 cases of patients with large area burn combined inhalation injury

Objective To prevent and reduce lower respiratory tract infection in the batch of patients with large area burn combined inhalation injury. Methods 9 cases of large area burn with inhalation injury patients were investigated of bacterial spectrum and drug resistance of lower respiratory tract secretion. Results In the survey, we detected a total of 38 strains of 2 kinds of the lower respiratory tract pathogen, including 37 strains of acinetobacter baumannii accounting for 97. 36% and 1 strain of eosinophilic malt pseudomonas accounting for 2.64%. Acinetobacter baumannii antibiotic resistant rate rised up to 75.59%. The sensitive rate of tigecy?cline and minocycline rised significantly (>90%) . After strict infection control, reasonable use of antibiotics and other comprehensive measures, we have obtained a good curative effect. The detection rate of acinetobacter baumannii declined obviously. Conclusion In large area burn with inhalation injury patients, acinetobacter baumannii is the most common in lower respiratory tract pathogen species. Although highly acinetobacter baumannii infection rate and drug resistance of lower respiratory tract secretion in the batch of patients with arge area burn combined inhalation injury, acinetobacter baumannii control can achieve good effect through effective disinfection i?solation, strict artificial airway infection prevention and control, reasonable application of antimicrobial agents and other methods.