ICU肺部感染患者的病原菌及耐药性特点分析

Clinical observation of bronchoalveolar lavage through fiber bronchoscopy in the treatment of patients with severe pulmonary infection

目的探讨重症医学科(ICU)患者肺部感染致病菌分布情况及耐药性特点,以指导临床合理使用抗菌药物。方法2009年1月～2012年5月在我院ICU收治的128例肺部感染患者的痰病原菌细菌谱,并对药敏结果进行分析。结果共检出病原菌167株,其中革兰氏阴性菌139株,占83.2%,革兰氏阳性菌28株,占10.8%。其中革兰氏阴性菌最主要的病原菌依次是阴沟杆菌、大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯氏菌。结论 ICU肺部感染患者的病原菌以革兰氏阴性菌为主,特点是多重耐药的阴沟杆菌、大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯氏菌更显著,革兰氏阳性菌及念珠菌检出率不高,这对抗菌药物的合理使用具有指导意义。

Objective To explore the intensive medicine （ ICU ） in patients with pulmonary infection of pathogenic bacteria dis- tribution and drug resistance characteristics, and to guide clinical rational use of antibaeterials. Methods From 2009 January to 2012 May in our hospital ICU treated 128 cases of patients with pulmonary infection of pathogenic bacteria in sputum bacterial spectrum, and the drug sensitivity results analysis. Results There were 167 strains of pathogens, including gram-negative bacteria strain 139, occupy 83.2% , gram positive bacteria strain 28, accounted for 10. 8%. Among them gram negative bacteria is the main pathogen followed by En- terobacter cloacae, Eseherichia coli, Pseudomonas aeruginosa, Bauman Acinetobacter, Klebsiella pneumoniae. Conclusion ICU pa- tients with pulmonary infection pathogen in Gram-negative bacteria, is characterized by multiple drug resistance of Enterobacter cloacae, Escheriehia coil, Pseudomonas aeruginosa, Bauman Aeinetobacter, Klebsiella pneumoniae is more significant, Gram-positive bacteria and Candida detection rate is not high, the rational use of antimierobial drugs with guidance meaning of