气管切开患者下呼吸道定植菌的病原学研究

目的探讨重症监护病房气管切开患者下呼吸道定植菌(LABC)的分布特点及其耐药性分析,为临床诊断LABC提供参考依据。方法对医院重症监护病房气管切开患者进行回顾性分析研究,对其下呼吸道进行支气管肺泡灌洗,并对灌洗液进行细菌定量培养及抗菌药物敏感性测定。结果 190例气管切开患者LABC检出率高达85.2%,培养出定植菌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%;肺炎克雷伯菌36株,居第2占15.5%;其次为鲍氏不动杆菌(12.1%)、大肠埃希菌(8.2%)、洋葱伯克霍尔德菌(4.3%)和嗜麦芽寡养单胞菌(3.4%),革兰阳性菌占14.7%,主要为金黄色葡萄球菌,真菌占6.5%,主要为白色假丝酵母菌;耐药监测结果显示,革兰阴性菌均出现较强的耐药性。结论加强对气管切开患者LABC的监测与控制,加强肺部综合护理才能防止定植菌转变为致病菌,减少再次感染的发生。

Lower Airway Bacterial Colonization in Patients with Tracheotomy:An Etiological Study

OBJECTIVE To investigate the etiological characteristics of lower airway bacterial colonization(LABC) in patients with tracheotomy in intensive care unit,and improve the prevention and diagnosis of LABC.METHODS Totally 190 admitted patients with tracheotomy in ICU were retrospectively analyzed of lower respiratory tract of bronchoalveolar lavage fluid,and lavage fluid was cultured and determined by antimicrobial susceptibility.RESULTS LABC detection rate was as high as 85.2% in 190 cases of patients with tr...