重症监护病房患者医院内获得性肺炎.pdf

《重症监护病房患者医院内获得性肺炎.pdf》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、第19卷第14期中国现代医学杂志Vol.19No.142009年7月ChinaJournalofModernMedicineJul.2009文章编号：1005-8982（2009）14-2196-03重症监护病房患者医院内获得性肺炎细菌学特点及其耐药性分析王小智，周森，韩魁，陈志乐（海南省农垦总局医院ICU，海南海口570311）摘要：目的探讨重症监护病房患者医院内获得性肺炎细菌分布特点及耐药情况。方法回顾性总结该院重症监护病房69例医院内获得性肺炎患者的临床资料、感染细菌谱及耐药性，并对相关因素进行分析。结果69例感染患者共

2、分离出细菌118株，以G-杆菌为主（占83.89％），G+球菌比例较低（占16.10％）。G-杆菌中铜绿假单胞菌占第1位（22.03％），其次为大肠埃希菌（20.33％）、肺炎克雷伯（16.94％)。G+球菌占16.10％，主要为金黄色葡萄球菌，其中耐甲氧西林金黄色葡萄球菌占70％。结论ICU患者医院内获得性肺炎的细菌以G-杆菌为主，且多重耐药，对重症感染患者应多种抗菌药物联合使用以减少细菌耐药率的发生，应根据药敏试验合理选用抗菌药物，动态监测抗生素耐药情况对患者积极有效的治疗至关重要。关键词：医院内肺炎；细菌学；耐药性中图分

3、类号：R563.11文献标识码：BAnalysisofnosocomialpathogensanddrugresistanceinpatientswithlowerrespiratorytractinfectioninintensivecareunitWANGXiaozhi,ZHOUSeng,HANKui,CHENZhile（GeneralHospitalofHainanProvincialBureauofAgriculturalReclamation.HaikouHainan570311,P.R.China）Abstract

4、:【Objectives】Toinvestigatethedistributionofpathogenicbacteriaandtheirantibioticresistanceinsenilepatientswithnosocomialpneumoniainintensivecareunit．【Method】Theclinicaldata,bacterialspectrtun,drugresistanceandrelatedfactorsofintensivecareunitpatientsinourhospitalwere

5、analyzedretrospectively．【Results】Atotalof118pathogensstrainswereidentifiedfromthesputumin69patients．Therateofgram-negativebacteriaandgram-positivebacteriawere83.8％and16.10％respectively．Pseudomonasaeruginosaranksthefirstofgram-negativebacteria,followedbyEscherichiaco

6、liandKlebsiellapneumoniaeaccountedfor20.33％and16.94％respectively．Amonggram-positivebacteriastrainstheStphylococusauruginosawasmainlysub-jects,therateofmethicillin-resistantStaphylococcusaureus(MRSA)was70％．【Conclusions】Gram-negativebacteria,whichpresentwithmulti-drug

7、resistantpattern,werethemostcommonpathogenicbacteriainsenilepa-tientswithnosocomialpneumoniainintensivecareunit．Inordertodecreasetherateofantibioticresistance,weshouldcombinateseveralantibioticsforseriousinfection．Thedrugsensitivitytestrequiredweresignificantinprope

8、rselectionofantibiotics．Monitoringthedrugresistanceofbacteriatoantibioticswillbevitalimportanttocuresenilepatientswithlowerrespiratorytrac