ICU患者下呼吸道感染常见革兰阴性菌的分布

目的研究医院重症监护病房(ICU)患者下呼吸道感染常见革兰阴性(G-)菌的分布与变迁,为临床合理使用抗菌药物提供依据。方法回顾性分析医院自2003年1月-2006年12月ICU患者736例痰标本所得的G-菌476株,阳性率64.67%,总结其分布及变迁。结果476株细菌主要为鲍氏不动杆菌129株、铜绿假单胞菌94株、肺炎克雷伯菌66株、大肠埃希菌54株、嗜麦芽寡养单胞菌33株。结论重症监护病房患者下呼吸道感染病原菌以G-菌为主,其中仍以鲍氏不动杆菌分离率最高,但嗜麦芽寡养单胞菌逐渐增多,提示临床医师应监测G-菌的变迁动态,合理使用抗菌药物,提高治愈率。

Distribution of Familiar Gram-negative Bacteria of Lower Respiratory Tract Infection for Patients in Intensive Care Unit: Analysis of Their Alteration

OBJECTIVE To review the alteration of distribution of familiar Gram-negative bacteria of lower respiratory tract infection for patients in intensive care unit(ICU) of our hospital for reference to rational administration of clinical antibacterial drug.METHODS The 476 strains out of 736 strains collected from patients of our hospital during Jan 2003 to Dec 2006 were Gram-negative bacteria,positive ratio was 64.67%,and the features of distribution and alteration were statistically summarized.RESULTS The main germs of the 476 strains were Acinetobacter baumannii(102 strains),Pseudomonas aeruginosa(94 strains),Klebsiella pneumoniae(66 strains),Escherichia coli(54 strains),and Stenotrophomonas maltophilia(33 strains).CONCLUSIONS The main germs of pathogenic germs of lower respiratory tract infection for patients in ICU are Gram-negative bacteria,among which the isolation ratio of A.baumannii is the highest.But S.maltophilia is increasing gradually,indicating that clinical doctor should watch alteration of Gram-negative bacteria,and rationally use antibacterial drug in order to raise cure rate.