脑出血昏迷患者肺部感染微生物学研究

Microbiology Study on Lung ＇Infection of Cerebral Hemorrhage Coma Patients

目的研究脑出血昏迷患者肺部感染病原菌及药敏特点，为临床诊治提供依据。方法随机选取2008年3月～2009年3月延安大学附属医院神经外科脑出血昏迷并发肺部感染患者65例，对其进行痰细菌培养及药敏试验。结果65例患者行痰细菌培养及药敏试验123次，培养菌株123株，其中分离出革兰氏阴性菌61％，革兰氏阳性菌35．8％，真菌3．2％。培养分离出致病菌依次为葡萄球菌属、肠杆菌属、假单胞菌属、链球菌属、克雷伯氏菌属，沙雷氏菌属。对革兰氏阴性菌敏感的抗生素依次为亚胺培南、丁胺卡那、加替沙星、氧哌嗪青霉素、左氧氟沙星。对革兰氏阳性菌敏感的抗生素依次为万古霉素、氧哌嗪青霉素、丁胺卡那、利福平、亚胺培南。结论脑出血昏迷患者肺部感染病原菌分布以革兰氏阴性菌为主，但葡萄球菌属感染率较高。亚胺培南及万古霉素仍为敏感抗生素。

Objective To investigate the characteristics of etiology bacteria and drug sensitive tests of cerebral hemorrhage coma patients,and provide useful information for clinical practice. Methods 56 cases of lung infection of cerebral hemor- rhage coma patients,who were treated from March, 2008 to March 2009 in Affiliated Hospital of Yah＇ an University,were analysed retrospectively. Sputum bacteria cultures and drug sensitive tests were emphatically implemented on them. Results From the 65 patients, 123 strains of bacteria were obtained,of which Gram negative bacilli accounted for 61%,Gram positive cocci 35.8~, and fungi 3. 2%. The most common isolated bacteria were Staphylococcus, Enteric bacilli,Pseu- domonas, Streptococus, Klebsiella and Salmonella. The sensitive gram negative organisms were imipenem, amikacin, gati- floxacin,piperacillin and levofloxacin. Vaneomycin, piperacillin,amikacin, rifampicin and imipenem were sensitivity of the Gram positive bacillus. Conclusion Gram negative bacilli ,etiology bacteria of cerebral hemorrhage coma patients will be basically realized. Imipenem and vancomycin were main sensitive bacteriophage.