重型颅脑外伤并发下呼吸道感染铜绿假单胞菌的临床分析

Lower respiratory tract infection by pseudomonas aeruginosa in severe brain trauma

目的了解重型颅脑伤患者并发下呼吸道感染铜绿假单胞菌的临床特点及药敏情况,为临床使用抗生素提供依据。方法回顾我院近2年来,重型颅脑损伤合并下呼吸道感染铜绿假单胞菌及药敏资料。结果重型颅脑伤患者并发下呼吸道感染中,铜绿假单胞菌占17.5%,肺炎克雷伯氏菌占11.7%,鲍曼溶血不动杆菌占10.7%,金黄色葡萄球菌(7.8%)。药敏试验结果显示铜绿假单胞菌对抗生素的耐药依次为亚胺培南(3·0%)、环丙沙星(4.8%)、氨基糖甙类抗生素(6.7%),氧哌嗪青霉素/他巴唑(9·0%),头孢他啶(13.3%)。结论铜绿假单胞菌已成为重型颅脑损伤并发下呼吸道感染的主要菌种,应根据药敏结果慎重用药。

Objective To investigate the clinical eharacteristie and drug sensitivity status of lower respiratory traet infection by pseudomonas aerugiuosa（PA） in severe brain trauma, in order to provide essential basis tot the treatment with antibiotics. Methods Rethospective survery respiratotry trael inteetion bv PA in severe brain trauma in our hospilal nearly two years, including the drug sensitivity resuh was conducted. Results Bacilli from severe brain trauma patients with lower respiratory infections diseases were PA （ 17. 5% ） , klebsiella pneumonieae （ 11. 7% ） , acinetobacter haumnnii （ 10.7% ）, staphylococcus aureus （7.8%）. The drug sensitivhy tests resuhs showed that PA was resistanee to imipenem （3.0%）, ciprofloxacin （4.8%）, amikaein （6.7%）, pereraeillin/thiamazole （9.0%）, ceftazidime （ 13.3% ）. Conclusion PA has becoming the major bacteria resptmsible for lower respiratory tracl infeetion in severe brain trauma, Selection of antibiotics for treatment should be base on the resuhs of drug suseeptibility.