急诊监护病房肺部感染的临床研究

目的探讨急诊监护病房（EICU）最常见肺部感染痰菌分布特点及耐药性。方法对125例EICU肺部感染患者痰培养结果及药物敏感试验进行分析。结果共检出致病菌109株,以革兰阴性杆菌（G-菌）为主,共71株（65.1%）,前四位分别为铜绿假单胞菌22株（20.2%）,其中嗜麦芽寡养单胞菌14珠（12.8%）,肺炎克雷伯菌10株（9.2%）,鲍氏不动杆菌9株（8.3%）;革兰阳性菌（G＋菌）28株（25.7%）,其中金黄色葡萄球菌16株（14.7%）;真菌10株（9.2%）,其中白色念珠菌占5.6%。药物敏感试验显示铜绿假单胞菌对抗生素多重耐药率较高,嗜麦芽寡养单胞菌对环丙沙星耐药率较低,肺炎克雷伯菌和鲍氏不动杆菌仍然对碳青酶烯类敏感。结论该组EICU肺部感染以G-杆菌为主;MRSA和真菌感染的比例较高,应根据药敏试验合理使用抗菌药物。

Clinical Study in Pulmonary Infection in Emergency Intensive Care Unit

Objective To explore the main pathogens in the sputum of patients with pulmonary infection and their drug resistance in emergency intensive care unit （EICU）, and to improve the prevention and treatment of pulmonary infection. Method 125 pulmonary infections cases in EICU were analyzed. The culture positive sputum samples were tested for drug sensitive. Result A total of 109 pathogen strains were isolated. The result showed that 71 were grame negative bacteria strains （65.1%）. The top four common strains were Pseudomonas aeruginosa （22 strains, 20.2% ）, Stenotrophomonas maltophilia （ 14 strains, 12.8% ）, Klebsiella pneumonia （ 10 strains, 9.2% ）, and Acinetobacter baumanii （9 strains, 8.3%）. 10 fungal strains were isolated （9.2%）, mainly Candida albicans （5.6%）. The result of drug sensitive test showed that P.aeruginosa strains were more multidrug resistant. S.maltophilia was less resistant to ciprofloxacin. K.pneumonia and A. baumanii were sensitive to carbapenems. Conclusion Gram negative bacilli is the main pulmonary infection pathogens among the pulmonary infection cases in EICU. The proportion between MRSA and fungal infection is increasing. Based on the drug sensitive test we can make a better choice of antimicrobial agents for the treatment.