脑出血昏迷并气管切开患者痰培养及药敏分析

The analysis of sputum culture and medicamentum susceptibility test in comatose patients with cerebral hemorrhage and tracheotomy

目的研究脑出血昏迷患者经气管切开后发生肺部感染的致病菌、药敏及耐药情况。方法回顾性分析2006年1月-2007年12月间56例脑出血昏迷患者气管切开术后痰细菌培养、药敏资料。结果56例患者112次痰培养阳性102次，阳性率91.07％。共培养出病原菌126株，其中G-菌76株，占60.32％；G^＋菌39株，占30.95％；真菌11株，占8.73％。混合感染27例，细菌与真菌混合感染10例。结论脑出血昏迷患者气管切开后呼吸道感染发生率较高，致病菌以G^-杆菌为主，但G^＋菌、真菌逐渐增加；病原菌的耐药、交叉耐药与多重耐药日趋普遍，早期、定期进行痰培养和药敏试验可确定致病菌，指导选用抗生素。

Objective To explore the pathogenic bacterium, medicamentum susceptibility and information of drug fast which were in trouble with nosocomial infection of lung in comatose patients dued to cerebral hemorrhage and tracheotomy. Methods The informations of sputum bacterial culture and medicamentum susceptibility were retrospective analyzed in 56 patients which were in coma dued to cerebral hemorrhage and tracheotomy during 2006-2008. Rosults In 112 sputum culture tests among 56 cases, the positive tests were 102, positive rate was 91.07%, and 126 strains pathogenic bacterium were cultured. Among 126 strains pathogenic bacterium, Gram negative bacterium were 76 strains（60.32%）, Gram positive bacterium were 39 strains（30.95%）, and fungi were ii strains （8.73%）. Conclusions The rate of respiratory tract infection was high in comatose patients dued to cerebral hemorrhage and tracheotomy, The pathogenic bacteria was master dued to the Gram negative bacilus, but the infection rate of the Gram positive coccus and fungus was increased gradually. The condition of drug fast, intersect drug fast and multiplicitas drug fast was generally day by day, lt can definite the pathogenic bacteria and guide to adoption antibiotic through sputum cultured and medicamentum susceptibility test in nonage or regularity.