神经外科重症监护病房气管切开患者痰培养首次阳性的病原菌分析

目的 了解神经外科重症监护病房气管切开患者下呼吸道感染的病原菌构成及药物敏感性,为临床抗感染药物的应用提供依据.方法 选择2010年1月至2011年10月我院神经外科重症监护病房气管切开患者51例,留取痰培养标本,分析痰培养首次阳性的病原菌构成及药物敏感试验结果.结果 51例气管切开患者全部发生下呼吸道感染;痰培养首次阳性结果中共培养出致病菌14种,共计感染69例次,主要为革兰阴性菌,占89.9％ (62/69),其中前3位为铜绿假单胞菌占27.4％( 17/62)、肺炎克雷伯菌占19.4％(12/62)、鲍曼氏不动杆菌占17.7％(11/62);药物敏感试验结果显示各菌对抗感染药物表现出严重耐药及多重耐药.结论 我院神经外科重症监护病房气管切开患者下呼吸道感染的病原菌主要为革兰阴性菌,病原菌耐药率较高.

The pathogens analysis of the first time positive of the sputum culture for patients with tracheostomy in neu-rosurgery intensive care unit

Objective To study the pathogens and the drug sensitivity among the patients with tracheotomy lower respiratory tract infection at neurosurgical intensive care unit and to provide the basis for the clinical empirical use of antibiotics. Methods To collect the sputum culture specimens of 51 cases with tracheotomy in a three-level hospital neurosurgery intensive care unit from January 2010 to October 2011 at Tangshan, and to analyze the drug sensitivity and pathogens constitute of the first positive results of sputum culture. Results The 51 cases of patients with tracheotomy were all infected at lower respiratory tract; 14 pathogenic bacteria were isolated from the first posi- tive results of sputum culture and 69 cases times were infected. Gram-negative bacteria infected 62 cases times which accounted for 89.9%. Among top three of them was Pseudomonas aeruginosa （ 17 accounted for 27.4% ）, Klebsiella pneumoniae （12 accounted for 19.4% ） and Acinetobacter baumanni （11 accounted for 17.7% ）. Drug sensitivity test showed severe resistance and multiple resistance to antibiotics. Conclusion The predominant patho- gens are Gram-negative bacteria among lower respiratory tract infection patients with tracheotomy and the bacterial resistance rate is high;the timely monitoring of bacterial resistance and detection of nosocomial infection risk factors is important.