气管插管全身麻醉患者术后肺部感染的病原菌特点和耐药性及高危因素分析

目的研究气管插管全身麻醉患者术后肺部感染的病原菌及耐药菌分布,并对引起感染的高危因素进行分析。方法选取2016年1月-2018年10月在本院气管插管全身麻醉术后肺部感染的68例患者,收集痰液细菌培养鉴定病原菌种及体外药敏试验,采用卡方检验和Logistic回归分析确定肺部感染的危险因素。结果68例发生肺部感染,肺部感染发生率为8.97%,共检出74株病原菌,其中革兰阴性菌占大多数。革兰阳性菌对万古霉素敏感;革兰阴性菌对美罗培南敏感。单因素和多因素Logistic回归分析显示,年龄、合并糖尿病、体质量指数、麻醉时间、术后拔管时间和经口气管插管方式是术后发生肺部感染的独立危险因素。结论气管插管全身麻醉患者术后肺部感染的病原菌以革兰阴性菌为主,对美罗培南敏感,其发生肺部感染危险因素较多,应针对预防。

Distribution characteristics,drug resistance and high risk factors analysis of pathogenic bacteria in postoperative pulmonary infection in patients undergoing general anesthesia with tracheal intubation

Objective To investigate the distribution of pathogens and drug-resistant bacteria in postoperative pulmonary infection in patients undergoing general anesthesia with tracheal intubation,and to analyze the risk factors of infection.Methods Sixty-eight patients with pulmonary infection after total anesthesia were enrolled in our hospital from January 2016 to October 2018.The pathogens were collected from sputum bacterial culture for in vitro susceptibility test.Chi-square test and Logistic regression were used to identify the risk factors for lung infection.Results In 68 cases of pulmonary infection,the incidence of pulmonary infection was 8.97%.A total of 74 pathogenic bacteria were detected,of which Gram-negative bacteri-a accounted for the majority.Gram-positive bacteria were sensitive to vancomycin;Gram-negative bacteria were sensitive to meropenem.Univariate and multivariate Logistic regression analysis showed that age,diabetes mellitus,body mass index,anesthesia time,postoperative extubation time,and oral tracheal intubation were independent risk factors for postoperative pulmonary infection.Conclusion The pathogens of postoperative pulmonary infection in patients with general anesthesia are mainly Gram-negative bacteria,sensitive to meropenem,and there are many risk factors for pulmonary infection.So,preven-tive measures should be taken.