肺部感染患者合理应用抗菌药物的研究

Research on lung infection prevention and rational use of antimicrobial drugs by pulmonary infected patients

目的对肺部感染的防治与抗菌药物合理用药展开分析,实现多药耐药医院感染的有效预防与控制,达到抗菌药物正确运用的目的。方法随机选取2010年12月-2013年12月接收治疗的200例肺部感染患者,通过细菌鉴定及药敏分析,对支气管肺泡灌洗液标本进行病原学检测及药敏试验,数据采用SPSS 12.0软件进行统计分析。结果 200例肺部感染患者支气管肺泡灌洗液培养分离病原菌阳性标本103例,阳性率为51.5%;共分离出135株病原菌,以革兰阴性菌为主,共88株占65.2%;鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌及大肠埃希菌对临床常规抗菌药物耐药性均较高,对氨苄西林、头孢曲松、头孢噻肟、头孢他啶、四环素、呋喃妥因等耐药率约达100.0%。结论肺部感染中常见病原菌以革兰阴性菌为主,医务人员要结合病原菌高耐药率、高分离阳性率的特征,合理运用抗菌药物控制病原菌的耐药性,采取针对性的干预措施。

OBJECTIVE To analyze the rational use of antibiotics and prevention of pulmonary infections so as to achieve effective prevention and control of multidrug-resistant hospital infections and the proper use of antimicrobial drugs.METHODS Totally 200 cases of pulmonary infected patients who received treatment in our hospital were randomly selected from Dec.2010 to Dec.2013.Etiological test and drug sensitive test were conducted to bronchoalveolar lavage fluid samples through bacteria identification and drug susceptibility analysis.All data were analyzed by SPSS 12.0software.RESULTS Totally 103 strains of positive pathogenic bacteria were isolated in the bronchoalveolar lavage fluid samples from 200 patients,with the positive rate of 51.5%.A total of 135 strains of pathogens were isolated,dominated by 88 strains of gram-negative bacteria which accounting for 65.2%.Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumonia,and Escherichia coli were found highly resistant to clinical ordinary antibiotics.And they were 100%resistant to ampicillin,ceftriaxone,ceftazidime,tetracycline,and nitrofurantoin.CONCLUSIONThe gram-negative bacteria is the most common pathogens in pulmonary infections.Medical staff should use antibiotics rationally to control the drug resistance of pathogens according to the features of high drug resistance rate and high positive rate of isolated bacteria and apply targeted intervention.