新生儿机械通气治疗气管导管末端细菌培养102例分析

目的探讨新生儿机械通气治疗下气管导管末端培养的常见病原菌及耐药情况。方法对102例呼吸机治疗的新生儿在拔管或者更换气管导管时取气管导管末端进行细菌培养及药敏试验,并分析培养结果与机械通气时间的关系。结果共检出病原微生物12株,总阳性率为11.76%。其中:革兰阴性菌8株,为肺炎克雷伯菌、荧光假单胞菌等;真菌4株,全部为白色假丝酵母菌。革兰阴性菌主要对亚胺培南、复方新诺明等敏感,对头孢他啶、头孢呋辛等普遍耐药。12例阳性结果中,有11例机械通气时间≥4 d。结论气管导管末端细菌培养阳性率多见于机械通气时间相对较长的患儿,且细菌全部为革兰氏阴性菌,对临床常用抗菌素普遍耐药。真菌检出率较高,且均为白色假丝酵母菌,但是否致病应结合临床具体分析。

Analysis of 102 Cases of Endotracheal Catheter Ends Microbial Culture in Neonatal Mechanical Ventilation

Objective To investigate common pathogenic bacteria and drug resistance in microbial culture at endotracheal catheter ends in newborns mechanical ventilation.Methods 102 cases of such patients have been collected when extubated or catheters replaced in the treatment of mechanical ventilation.We analyzed the relationship between culture results and duration of mechanical ventilation.Results 12 pathogenic microorganisms were detected and the total positive rate is 11.76%.8 strains Gram-negative bacteria are Klebsiella pneumoniae,Pseudomonas fluorescens.etc;4 strains of fungi are all white yeast.Gram-negative bacteria are sensitive to imipenem,cotrimoxazole,etc and wide-spreadly resistant to ceftazidime,cefuroxime.Conclusion Positive results of microbial culture at the endotracheal catheter ends are more common in relatively long duration of mechanical ventilation therapy in neonates.Pathogenic bacteria are all gram-negative strains which are generally resistant to clinical commonly used antibiotics.Fungi detection rate is higher,and all are Candida albicans.However,pathogenicity of the fungi should be analyzed clinically.