脑外伤患者开颅术后肺部感染病原菌耐药性监测

Drug resistance monitoring of pathogens causing lung infections in cerebral trauma patients after craniotomy

目的探讨脑外伤患者开颅术后肺部感染的病原菌分布特点及耐药性,为临床治疗提供参考依据。方法回顾性分析2013年5月-2014年6月收治的60例脑外伤开颅术后发生肺部感染患者的临床资料,对肺部感染的病原菌及药敏试验结果进行统计分析,数据采用SPSS 17.0软件进行统计分析。结果脑外伤患者开颅术后发生肺部感染送检标本培养出病原菌118株,以革兰阴性菌为主,共83株占70.3%;所有革兰阴性菌对头孢他啶、左氧氟沙星耐药率均>50.00%,革兰阳性菌对头孢唑林、青霉素、阿奇霉素、环丙沙星及苯唑西林等的耐药率均>50.00%。结论鲍氏不动杆菌、铜绿假单胞菌及肺炎克雷伯菌是脑外伤患者开颅术后发生肺部感染最常见的病原菌,且耐药性严重,加强细菌培养检测和药敏试验,选择适宜的抗菌药物及时给予治疗。

OBJECTIVE To explore the distribution features and drug resistance of pathogens causing pulmonary infections in patients with cerebral trauma after craniotomy so as to provide references for clinical treatments. METHODS The clinical data of 60 cerebral trauma patients with pulmonary infections after craniotomy admitted from May 2013 to Jun. 2014 were retrospectively analyzed. The pathogens^and drug sensitivity test results were statistically analyze＆ SPSS 17.0 was explored for statistical analysis. RESULTS Totally 118 strains of bacteria had been cultivated from the inspected sample of the patients with lung infections after the s cerebral trauma, dominating by gram-negative bacteria with 83 strains （70.3 %）. The drug resistance rates of all, gram-negative bacteria to eeftazidime and levofloxacin were over 50.00%. The drug resistance rates of all gram-positive bacteria to cefazolin, penicillin, azithromycin, ciprofloxacin and oxaeillin were over 50.0%. CONCLUSION The Acinetobacter baurnannii, Pseudornonas aeruginosa and Klebsiella pneumonia were common pathogens causing lung infections in cerebral trauma patients with craniotomy and they have severe drug resistance to antibiotics. The bacterial culture tests and drug sensitivity tests need to he strengthened and proper antibiotics should be given in time.