胸部外科术后并发肺部感染的病原菌分析及防治措施

目的 探讨胸部外科手术后并发肺部感染的病原菌分布特点及耐药性,总结感染的防治措施.方法 回顾性分析医院2008年3月-2010年3月48例胸外科术后并发肺部感染患者的临床资料,统计48例患者肺部感染的病原菌及药敏试验结果,总结肺部感染的防治措施.结果 48例肺部感染患者痰培养共检出病原菌77株,其中铜绿假单胞菌23株占29.9％,肺炎克雷伯菌20株占26.0％,嗜麦芽寡养单胞菌17株占22.1％,大肠埃希菌6例占7.8％,其他病原菌11株占14.3％；48例患者根据检验结果及药敏试验,选取针对性的抗感染药物进行治疗,45例患者痰细菌培养转阴,3例患者发生多器宫功能衰竭死亡.结论 根据痰细菌培养及药敏试验结果,结合患者的实际情况,选择相应的抗感染药物及治疗方法,可以使胸部外科手术术后肺部感染患者获得良好预后.

Pathogens causing pulmonary infections after thoracic surgery and preventive measures

OBJECTIVE To investigate the distribution and drug resistance of the pathogens causing pulmonary infections after thoracic surgery,and summarize the preventive measures for infections.METHODS A total of 48 patients with pulmonary infections after thoracic surgery from Mar.2008 to Mar.2010 were analyzed retrospectively.Pathogens isolated from 48 patients were analyzed and drug susceptibility testing was performed.Control measures for pulmonary infection were summarized.RESULTS Totally 77 strains of pathogens were detected from 48 patients with pulmonary infection,including 23 Pseudomonas aeruginosa isolates,accounting for 29.9%;20 Klebsiella pneumoniae isolates,accounting for 26.0%;17 Stenotrophomonas maltophilia isolates,accounting for 22.1%;6 Escherichia coli isolates,accounting for 7.8%,and 11 strains of other pathogens,accounting for 14.3%.Forty-eight patients selected the targeted anti-infective drugs for treatment based on laboratory test and susceptibility test results.There were 45 cases of sputum negative patients,three patients were dead due to multiple organ failure.CONCLUSION According to the results of sputum culture and drug susceptibility test,using the appropriate anti-infective drug and treatment method based on the patient′s actual situation can make the patients with pulmonary infections have a good prognosis after surgery.