122例多重耐药菌感染患者分析及护理

Analysis and nursing of 122 cases of multi drug resistant bacteria patients

目的分析我院呼吸科多重耐药菌患者的病原菌分布及特点,提出对患者有效的护理干预措施。方法首先对我院2013年1月至2014年8月间122例下呼吸道痰标本进行分离培养,然后对所有菌株鉴定和药敏结果进行分析,得出结论,随之探讨多重耐药菌感染特点及护理对策。结果 128株分离菌中革兰氏阴性菌120株(93.6%);革兰氏阳性菌8株(6.4%)。革兰氏阴性菌以大肠埃希菌28株(21.9%)居于首位,其次是鲍曼不动杆菌27株(21.1%),阴沟肠杆菌13株(10.2%),铜绿假单胞菌12株(9.4%)。革兰氏阳性菌主要为金黄色葡萄球菌占6株(4.7%)。AECOPD、COPD和肺心病为我科主要的多重耐药菌感染者。AECOPD、COPD、肺心病和肺部感染主要的病原菌是大肠埃希菌、鲍曼不动杆菌和阴沟肠杆菌。结论通过调查提示对AECOPD、COPD和肺心病患者,护理工作应该在最早时间进行消毒和隔离,尽早进行多重耐药菌和药物敏感试验检测,严格执行消毒隔离措施,最终有效预防和控制了多重耐药菌的传播。

Objective To analyze the distribution of pathogenic bacteria and the characteristics of multi drug resistant bacteria in our hospital department of respiration patients , put forward to the nursing intervention measures of patients with effective .Methods First, on 122 cases of lower respiratory tract sputum samples were isolated and cultured in our hospital in 2013 January -2014 year in August , then carries on the analysis of all the strains, identification and drug sensitivity results are concluded , then explore the characteristics and nursing strategy of multi drug resistant bacteria infection .Results 128 strains of gram negative bacteria isolates 120 strains （93.6%）;gram positive bacilli 8 isolates （6.4%）.Gram negative bacteria to 28 strains of Escherichia coli （21.9%） in the first place, followed by Bauman 27 Acinetobacter strains （21.1%）, 13 strains of Enterobacter cloacae （10.2%）, 12 strains of Pseudomonas aeruginosa （9.4%）.Gram positive bacteria were mainly Staphylococcus aureus strains accounted for 6 （4.7%）.AECOPD, COPD and pulmonary heart disease in our department for multi drug resistant bacteria mainly infected .AECOPD, COPD, pulmonary heart disease and pulmonary infection pathogens is mainly Escherichia coli , Bauman Acinetobacter and Enterobacter cloacae . Conclusions Through the investigation of patients with AECOPD , suggesting that COPD and pulmonary heart disease , nursing work should be carried out in the early time of disinfection and isolation , as early as the multiple antibiotic resistant bacteria and drug sensitivity test of detection , strict implementation of disinfection and isolation measures, spread ultimately effective prevention and control of the multi drug resistant bacteria .