机械通气致下呼吸道黄杆菌属感染的临床研究

A clinical study on lower respiratory tract infections caused by Flavobacterium after mechanical ventilation

目的研究机械通气导致下呼吸道黄杆菌属感染的临床特点、黄杆菌属对抗菌药的敏感性,探讨预防措施。方法对医院加强医疗室2001-2010年30例行机械通气发生下呼吸道黄杆菌属感染的临床资料进行回顾性调查。结果 30例机械通气发生下呼吸道黄杆菌属感染的病例均有基础疾病、长期应用多种抗菌药史;共分离出30株黄杆菌属,主要为脑膜脓毒金黄杆菌,占33.33%;黄杆菌属对红霉素、环丙沙星、磺胺甲噁唑/甲氧苄啶、克林霉素、万古霉素、利福平较敏感;30例患者死亡2例,死亡率为6.7%。结论黄杆菌属引起的下呼吸道感染多发生在老年、有基础疾病、应用广谱抗菌药、进行机械通气治疗的患者,黄杆菌属耐药率较高;严格落实清洁、消毒、隔离措施、无菌操作规程,可以预防黄杆菌属的感染。

OBJECTIVE To explore the clinical characteristics of lower respiratory tract infections caused by Flavobacterium after mechanical ventilation, the susceptibility of Flavobacterium to antimicrobial agents so as to propose preventive measures. METHODS A total of 30 medical records of patients with lower respiratory tract infection caused by Flavobacteriurn after mechanical ventilation in ICU during 2001-2010 were investigated retrospectively. RESULTS All of 30 patients with Flavobacterium infections who underwent mechanical ventilation were complicated with underlying diseases and were with long-term use of antibiotics~ of 30 strains of Flavobacterium isolated, Staphylococcus bacteria meningeal sepsis was the major species, accounting for 33.33%; Flavobacteriurn were susceptible to erythromycin, ciprofloxacin, trimethoprim/sulfamethoxazole, clindamycin, vancomycin, and rifampicin;2 of 30 patients were dead with the mortality of 6.7%. CONCLUSION Lower respiratory tract infections caused by Flavobacterium mainly occur in patients who are elderly, suffered from underlying diseases, used broad-spectrum antibiotics, and underwent mechanical ventilation; the drug resistance rates of Flavobacterium are high; strictly fulfilling the cleaning, disinfection, isolation and aseptic techniques can prevent infections caused by Flavobacterium.