严重多发伤患者下呼吸道感染病原菌的分布及耐药性分析

目的 分析严重多发伤患者下呼吸道感染病原茵的分布及耐药情况.方法 对我院重症监护病房(ICU)2008年1月至2009年12月39例严重多发伤下呼吸道感染患者痰培养及药物敏感结果进行分析.结果 39例患者分离出细菌92株,革兰阴性菌61株(66.3%),以铜绿假单胞菌、肺炎克雷伯菌、大肠埃希茵、鲍曼不动杆菌为主;革兰阳性菌22株(23.9%),以金黄色葡萄球菌为主;真菌9株(9.8%),以白色念珠菌为主.鲍曼不动杆菌和金黄色葡萄球菌检出率上升.结论 我院ICU严重多发伤下呼吸道感染患者病原菌以革兰阴性杆菌为主.亚胺培南、美罗培南仍然是控制革兰阴性杆菌感染的最有效药物,革兰阳性球菌对万古霉素敏感.

Distribution of pathogens and drug resistance in lower respiratory tract infection in patients with severe multiple injuries

Objective To intestigate the distribution and drug resistance of pathogens in lower respiratory tract infection（LRTI） in patients with severe multiple injuries in the Intensive Care Unit（ICU）. Methods Restrospective study of the sputum culture and the drug sensitivity of the pathogens were studied on 39 LRTI cases with severe multiple injuries in ICU from Jan. 2008 to Dec. 2009. Results Totally 92 strains of pathogens were identified. The ratio of gram-negative bacteria to total pathogens isolated was 66.3%, the main kinds of the gram-negative bacteria were Pseudomonas aeruginosa, Klebsiella pneumoniae, Eseherichia coli and Acinetobacter baumannii. The gram-positive bacteria were 23.9~ ,mainly including Staphylococcus aureus. The fungi were 9.8% ,C. albican was the most common species. The isolating rates of Acinetobacter baumannii and Staphylococcus aureus were increased. Conclusion Gramnegative bacteria are the majority of the pathogens isolated from LRTI in patients with severe multiple injuries in ICU. Imipenem and merpenem are relatively active against the gram-negative bacteria. Vancomycin is sensitive to Staphylococcus aureus.