机械通气患者气管内导管生物被膜的观察

目的研究机械通气患者气管内导管生物被膜的形成情况以及生物被膜的形态和病原学分布特征及耐药性. 方法前瞻性研究了27例施行人工气道(气管插管和气管切开)并机械通气的患者拔除的气管内导管,分别进行扫描电镜观察生物被膜的形成,并进行细菌培养及耐药性检测. 结果 27例气管导管中培养阳性25例,占92.6%,以粪肠球菌、金黄色葡萄球菌及铜绿假单胞菌最常见,均呈高度耐药,但与痰培养结果差异无明显性;扫描电镜观察26例均可见膜状物,并可见细菌团状聚集,其间可见纤维样物质交联,膜状物中可见网状裂纹,其上附着大量细菌. 结论机械通气时气管内导管表面易黏附细菌,形成生物被膜,生物被膜的形成可能与VAP的发生有关,并常常导致难治性感染.

Biofilms Inside Endotracheal Tubes from Intubated Patients

OBJECTIVE To observe the formation of biofilms inside endotracheal tubes and to evaluate the (characteristic) of pathogen. METHODS Biofilms inside endotracheal tubes from intubated patients were observed by scanning electron microscopy, meanwhile bacteria were detected in the specimens from endotracheal tubes and identified bacteria resistant to antibiotics. RESULTS In 92.6% of endotracheal tubes were detected bacteria, in which TBXStaphylococcus aureus, Enterococcus faecalis and Pseudomonas aeruginosa were the main pathogens. Of 27 endotracheal tubes, 26 tubes were coated with matrix by scanning electron microscopy. A great deal of bacteria adhered the matrix and clusters of bacteria cells were seen. CONCLUSIONS Bacterial biofilm can form inside endotracheal tube. The presence of biofilms might be associated with the pathogenic organisms and cause the intractable (bacterial) respiratory infection.