重度脑外伤院内下呼吸道感染病原菌分布及其耐药性监测

目的探讨重度脑外伤院内下呼吸道感染细菌谱及耐药情况。方法 回顾1998年1月—2003年12月神经外科病房196例下呼吸道分泌物培养及药敏结果。结果 重度脑外伤患者院内下呼吸道感染常见病原菌为鲍曼不动杆菌(37．2％)、金黄色葡萄球菌(31．6％)、肺炎克雷伯菌(27．0％)、铜绿假单胞菌(25．5％)及真菌；其中鲍是不动杆菌、肺炎克雷伯菌及铜绿假单胞菌对亚胺培南西司他丁高度敏感，金黄色葡萄球菌对糖肽类万古霉素未发现耐药。结论 重度脑外伤患者误吸、长期使用广谱抗生素及大剂量使用激素是院内下呼吸道感染的主要原因。

Distribution of the patterns of bacterial strains in lower respiratory tract infection in hospitalized patients with severe brain trauma and monitoring the durg resistance of bacterias

Objective To investigate the patterns of bacterial strains in lower respiratory tract infection in hospitalized patients with severe brain trauma and the drug resistance of bacterias.Methods Analyse retrospectively the results of the lower respiratory tract secretion cultivation and the drug sensitivity test of 196 cases in neurosurgery ward from January 1998 to December 2003.Results Gramnegative bacillus found in most patients with sever brain trauma. The prevalences of strains in isolates of A. baumannii, S.aureus, K. pneumoniae, P. aeruginosa were 37.2%, 31.6%, 27.0% and 25.5% respectively. The drug sensitivity rates of Imipinem to A. baumannii, K. pneumoniae and P. aeruginosa were the highest, S.aureus had no drug resistance rate to Vancomycin.Conclusions Aspiration,the long-term wide-spectrum antibiotic and high dose corticosteroids are main reasons which lead to lower respiratory tract infection in hospital.