腹部手术后肺部感染痰涂片、培养及药敏分析

Analysis on Sputum Smear, Culture and Drug Sensitivity of Nosocomial Pneumonia in the Postoperative Patient

目的 :了解腹部手术后肺部感染的细菌分布及药敏情况。方法 :对 1997年 1月～ 2 0 0 0年 8月期间属腹部手术后肺部感染获送检的 738个痰标本进行回顾性调查分析。结果 :腹部手术后肺部感染的最常见病原体依次为鲍曼不动杆菌、铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷伯菌、表皮葡萄球菌和阴沟肠杆菌。大多数细菌均有较高程度的耐药性。革兰阳性菌对万古霉素的敏感率达 98.9% ,革兰阴性杆菌对头孢拉啶的敏感率为 5 1.3%。痰标本合格率为 71.7%。结论 :万古霉素和(或 )头孢拉啶可作为经验性治疗腹部手术后严重肺部感染的首选用药。痰涂片不但可以判断痰标本是否合格 ,还可以判断肺部感染是否被控制。

Objective: To study bacteria and drug sensitivity of nosocomial pneumonia in the postoperative patient. Methods: Between January 1997 and August 2000, 738 sputum specimens of nosocomial pneumonia in the postoperative patient were studied retrospectively. Results: The most common organisms were Acinetobacter baumanii, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumonia, Staphylococcus epidemidis and Enterobacter cloacae. The bacterial pathogens isnolated demonstrated a marked pattern of antibiotic resistance. Gram positive bacteria were sensitive to vancomycin with a sensitivity of 98.9%, and Gram negative bacteria were sensitive to ceftazidine with a sensitivity of 51.3%. Quality rate of sputum specimens was 71.7%. Conclusion: Vancomycin and (or) ceftazidine may be first chosen to treat nosocomial pneumonia in the postoperative patient. Sputum smear can not only judge whether sputum specimens are quality, but also judge whether nosocomial pneumonia is controled.