康复科昏迷患者肺部感染的病原学特点分析

Pathogenic characteristics analysis of pulmonary infection in rehabilitation patients with coma

目的探讨康复科昏迷患者肺部感染的病原学特点,为临床抗感染药物的合理使用提供依据。方法回顾性分析87例康复科昏迷合并肺部感染患者痰病原学特点,总结细菌分布种类及构成比,并总结主要细菌对常用抗生素的药敏情况。结果 87例昏迷患者合并肺部感染痰培养结果显示革兰氏阴性菌75株(77.3%),革兰氏阳性菌15株(15.5%),真菌7株(7.2%),合并两种菌感染的患者有10例,占患者数的11.5%。痰培养细菌学以革兰氏阴性菌为主,主要为铜绿假单胞菌、肺炎克雷伯杆菌和鲍曼不动杆菌。革兰氏阳性菌以金黄色葡萄球菌为主。结论康复科昏迷患者肺部感染病原菌主要为革兰氏阴性菌,且多为多重耐药菌,早期应该给予针对多重耐药菌的敏感抗生素进行治疗。

Objective To investigate the pathogenic characteristics of pulmonary infection in rehabilitation patients with coma, and to provide the basis for rational use of anti infective drugs in clinic. Methods The characteristics of sputum bacteriology in 87 cases of rehabilitation medical department patients with coma and pulmonary infection were retrospectively analyzed. The distribution, species and constituent ratio of bacteria were summarized, and the sensitivity of main bacteria to common antibiotics was summarized. Results In 87 cases of coma patients with pulmonary infection, the sputum culture results showed that gram negative bacteria in 75 strains（77.3%）, gram positive bacteria in 15 strains（15.5%）, fungi in 7 strains（7.2%）. Ten cases were combined with two kinds of bacteria infection, accounting for 11.5% of the total of patients.The main pathogens of sputum culture were gram negative bacteria, mainly Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii. Gram positive bacteria were mainly Staphylococcus aureu. Conclusion The main pathogenic bacteria of pulmonary infection with coma patients in rehabilitation medical department are mainly gram negative bacteria, and most of them are multi drug resistant bacteria. Early stage should be given antibiotics for multiple antibiotic resistant bacteria.