机械通气患者下呼吸道感染病原菌分布特点

The distribution characteristics of respiratory infection pathogen in patients with mechanical ventilation

目的分析机械通气患者下呼吸道感染的病原菌分布特点,以指导临床用药及了解临床上机械通气的注意事项。方法对2005年1月至2010年10月重症监护病房100例机械通气患者的临床资料及其下呼吸道感染病原菌构成进行分析。结果 100例患者共分离出菌株226株。培养结果以革兰阴性杆菌为主(155株,68.58%),其中主要为铜绿假单胞菌、不动杆菌属。真菌占第2位,共44株,占19.47%,以白色念珠菌为主。革兰阳性球菌占第3位(27株,11.95%),以金黄色葡萄球菌为主。铜绿假单胞菌对抗菌药物敏感性较高,敏感性在70%以下的只有哌拉西林。结论重症监护病房患者年龄大,多有基础疾病,在机械通气的状态下患者极易发生混合病原菌感染,且存在多重耐药,应动态监测细菌的耐药性,合理选择抗菌药物。

Objective To understand the distribution characteristics of respiratory infection pathogen in patrents with mechanical ventilation,in order to instruct clinical medicine and find out the matters need attention in mechanical ventilation. Methods The clinical information of 100 patients with mechanical ventilation in the respiratory department of our hospital from January 2005 to October 2010 were analyzed. Results 226 strains were isolated from 100 cases. Most of the strains were gram negative bacilli（n = 155,68.58% ）, including P. aeruginosa, acinetobacter. The second was the fungi（n = 44,19.47%）, especially the candida albicans, and the third was the gram positive cocci （n= 27,11.95%） ,mainly the staphylococcus aureus. Conclusion Many patients in the ICU are aged people with ordinary illnesses,therefore mixed infection could easily happen during mechanical ventilation. The drug resistence of the bacteria should be monitored dynamically,and the medicine should be chosen properly.