神经外科重症监护病房获得性肺部感染的临床分析

Clinical analysis of acquired pulmonary infection in intensive care unit of neurosurgery

目的了解神经外科重症监护病房(NICU)获得性肺部感染的病原菌流行病学特点及耐药情况。方法回顾性分析近3年NICU肺部感染患者痰培养检出的致病菌株及其耐药特性。结果共分离致病菌306株,其中G-菌229株(74.8%),G+菌69株(22.5%),真菌8株(2.6%)。G-菌中以铜绿假单胞菌、克雷伯菌、不动杆菌、大肠埃希菌为主,G+菌中金黄色葡萄球菌占绝对多数。亚胺培南和万古霉素分别对G-菌和金黄色葡萄球菌保持较高的敏感率,其余抗菌素均耐药严重。结论NICU肺部感染仍以G-菌为主,但G+菌有逐渐增加的趋势;做好病原菌流行病学和耐药情况监测,可指导合理使用抗菌素;综合性的防治措施应予以重视。

Objective To investigate the prevalence of acquired pulmonary infection and the resistance of bacteria in intensive care unit of neurosurgery（NICU）. Methods The bacteria isolated from the sputum of the patients with craniocerebral disease in NICU in the last three years were retrospectively analyzed and their resistence were inspected. Results Three hundred and six strains of bacteria were separated out of all the bacterial organisms. Gram-negative bacteria, Gram-positive bacteria and fungi accounted for 229 strains（74.8%）, 69 strains（22.5% ）8 strains（2.6%）respectively. The main strains of the Gram-negative bacteria were pseudomonas aeruginosa,Klebsiella pneumoniae,and Echerichia coli . Most of the Gram-positive bacteria were staphylococcus aureus. Emipenem and vancomycin still keeped higher sensitive to Gram-negative bacteria and Gram-positive bacteria respectively, but others had seriously resistant. Conelusion The Gram-negative bacteria are the major pathologic strains of pulmonary infection in NICU while the Gram-positive bacteria take place more often than before. The epidemiological data and detection in bacterial resistance may be help ful to use properly antibiotics. In order to control pulmonary infection,we should recoginize the importance of the integrated measure of prevention.