气管切开术后肺部感染的病原菌分布及护理措施

Distribution of pathogens causing pulmonary infections after tracheotomy and nursing interventions

目的探讨颅脑外伤患者气管切开术后肺部感染病原菌的耐药性及预防护理措施。方法回顾性调查78例医院颅脑外伤气管切开术后肺部感染患者的病历资料,并制定医院感染的预防与护理措施。结果 78例患者肺部感染性标本中培养出105株病原菌,其中革兰阴性杆菌占68.6%;革兰阳性球菌占25.7%,真菌占5.7%;病原菌均为耐药细菌:包括铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌、大肠埃希菌、嗜麦芽寡养单胞菌、耐甲氧西林金黄色葡萄球菌(MRSA)等。结论医院感染管理部门和护理部应制定有效的干预措施,修定护理制度,完善护理程序,预防与控制医院感染的发生与暴发流行。

OBJECTIVE To approach the antimicrobial resistance and prevention and nursing interventions in hospital acquired pulmonary infections after tracheotomy among craniocerebral injury patients.METHODS The retrospective review was performed for 78 cases of hospital acquired pulmonary infections after tracheotomy among craniocerebral injury patients to institute prevention and nursing interventions.RESULTS Totally 105 strains of pathogenic bacteria were isolated from 78 infective specimens.The gram-negative bacilli,gram-positive cocci and fungi accounted for 68.6%,25.7% and 5.7%,respectively.The pathogenic bacteria comprised Pseudomonas aeruginosa,Klebsiella pneumonia,Acinetobacter baumannii,Escherichia coli,Stenortrophomonas maltophilia,methicillin-resistant Staphylococcus aureus（MRSA）,etc.CONCLUSION The nosocomial infection management and nursing departments should institute the effective interventions,revise the nursing regulations and consummate care program to prevent and control the occurrence,outbreak and prevalence of nosocomial infections.