呼吸科重症监护病房下呼吸道感染病原菌分布

目的研究该院呼吸科重症监护病区(ICU)医院获得性下呼吸道感染病原菌分布及耐药,为临床医生提供防治依据.方法对住院时间＞48h的患者咳痰,气管插管吸引痰标本,涂片、培养及药敏试验.结果 ICU病区下呼吸道感染细胞分离率为75%,其中革兰阴性杆菌85.0%,革兰阳性球菌4.6%.革兰阴性杆菌中,铜绿假单胞菌占32.3%,鲍曼氏不动杆菌占12.4%.药敏实验结果显示革兰阴性杆菌对头孢哌酮/舒巴坦,亚胺培南,哌拉西林/他唑巴坦和左旋氧氟沙星敏感性较高,铜绿假单胞菌对亚胺培南耐药率有明显增加趋势.结论铜绿假单胞菌、不动杆菌等革兰阴性杆菌是该院呼吸病房ICU病区院内获得性下呼吸道感染最主要的致病菌.

Distribution of pathogenic bacteria in lower airway infection in respiratory intensive care unit

Objective: To research the distribution and drug resistance of the pathogenic bacteria in the lower airway infection in the respiratory intensive care unit(RICU). and give the clinical doctors useful information for better management of the lower airway infection in RICU. Methods: The secretion of lower respiratory tract was cultured with quantitative methods and drug -sensitivity test was detected with disk diffusion method. Result: The separation rate of pathogenic bacteria in lower airway infection in the RICU was 75%. 85% of them were gram negative bacilli, 4.6% were gram positive cocci. 32.3% of gram negative bacilli was P. aeruginosa, 12.4% was Acinetobacter Baumannii. Drug-sensitive experiment showed the gram negative bacilli had high sensitivity to cefoperazone/sulbactam, imipenem, piperacillin/tozobactam and levo-floxacin, while the resistance of P. aeruginosa to imipenum had obviously increased. Conclusion: P. aeruginosa and Acinetobacter Baumannii are major pathogenic bacteria in the lower airway infection in the RICU in our hospital.