神经外科重症监护病房肺部感染173例临床分析

Analysis of 173 cases of pulmonary infection in NICU

目的探讨神经外科重症监护病房（NICU）肺部感染的易感因素、病原体的构成及药敏情况，指导临床有效预防及合理治疗。方法回顾性分析2010年1月至2011年9月NICU肺部感染痰培养检出的致病菌株及其耐药性、易感因素。结果其分离出细菌602株。其中G-菌363株（60．2％）；G＋菌71株（11．8％）；霉菌168株（28．0％）。G-菌中以不动杆菌、铜绿假单胞菌为主。G＋菌以表皮葡萄球菌为主。结论不动杆菌已成为NICU内肺部感染的优势菌群，对临床常用抗生素有多重耐药现象。尽快进行痰液细菌学检查以明确病原菌，根据药敏结果有针对性地选用抗生素是控制危重患者肺部感染的有效措施。

Objective To explore the risk factors, composition of pathogen and drug sensitivity of pulmonary infection in neurosurgical intensive care unit（NICU） and provide basis forclinical effective prevention and appropriate treatment. Methods Retrospective analysis the detected pathogenic strains, theirdrug resistance and predisposing factors of the cases of pulmonary infection in NICU from January 2010 to September 2011. Results Among the isolated 602 bacteriastrains,363 strains（60. 2% ）were G- bacteria,71 strains（ 11.8 % ） were G ＋ bacteria, 168 strains （ 28 % ） were molds. In G - bacteria, the main strains are acinetobacter and pseudomonas aeruginosa, and in G＋ bacteria, staphylococcus epidermidis based most. Conclusion Acinetobacter has become the dominant flora of pulmonary infection in NICU and it has muhidrug resistance to antibiotics in clinical. The Specific pathogen should be indentified through bacteriological examination of sputum as soon as possible, and the antibiotics should be used alternatively based on their drug sensitivity to control lung infection in critically ill patients.