外科重症监护病房获得性肺部感染的临床分析

Lung Nosocomial Infection in Surgical SICU:a Clinical Analysis

目的探讨外科重症监护病房(SICU)获得性肺部感染的病原学分布及耐药情况。方法回顾性分析487例SICU出院患者中的医院获得性肺部感染病例的临床资料。结果 487例SICU住院患者中发生医院内获得性肺部感染96例,感染率为19.71%,颈椎外伤伴高位截瘫、重度胸外伤、多发伤和颅脑损伤重症患者是肺部感染的高危人群,重症监护病房肺部感染病原菌以G-杆菌为主(78.67%),且多为多重耐药株;G+球菌以MR-SA为主,对万古霉素和替考拉宁敏感。结论 SICU患者医院内获得性肺部感染发生率较高,致病菌仍以革兰氏阴性菌为主,应建立SICU获得性感染监测制度,合理使用抗菌药物,并采取积极的预防和控制措施。

Objective To investigate the characters of lung noscomial infection in surgical intensive care unit（SICU）of our hospital.Methods Retrospective investigation was used to analyze the lung nosocomial infection cases in 487 patients with severe surgical disease discharged from SICU.Results Of 487 inpatients,96 developed lung nosocomial infection with an infection rate of 19.71%.Patients with cervical injury and high paraplegia,severe chest trauma,multiple injury or craniocerebral injury were the high risk group.The most prevalent pathogens of lung nosocomial urinary infection in SICU were gram-negative bacillus（78.67%）and most strains were multidrug resistant.Most gram-positive strains were methicillin-resistant Staphylococcus aureus.The main sensitive antibiotics to gram-positive strains were Vancomycin and teicoplanin.Conclusion Nosocomial lung infection rate in patients in SICU was high.Close attention should be paid to high-risk patients.The illegal use of antibiotics should be limited.