外科重症监护室气管插管患者肺部感染的细菌药敏分析

Bacterial susceptibility analysis of pulmonary infection patients in the surgical intensive care unit with endotracheal intubation

目的 :探讨外科重症监护室气管插管患者肺部感染的细菌药敏情况。方法 :选择2012年8月~2014年2月在我院外科重症监护室诊治的120例患者,对肺部感染发病情况与临床资料进行调查;分离肺部感染患者的病原菌并纳入六种药物的药敏分析。结果 :120例患者发生肺部感染43例,发生率为35.8%,其中死亡4例。多元多因素条件logistic回归模型结果发现年龄、导尿、动静脉插管、联合使用抗生素是导致肺部感染的主要独立危险因素。43例患者分离出病原菌43株,其中革兰氏阴性菌28株,革兰氏阳性菌11株,真菌4株。革兰氏阴性菌对头孢呋辛、左氧氟沙星、头孢唑林的敏感率都比较低。结论 :外科重症监护室气管插管患者的肺部感染发生率比较高,预后比较差,病原菌多为革兰氏阴性菌,要积极根据药敏情况合理选择抗生素。

Objective To investigate the bacterial susceptibility effects of pulmonary infection in the surgical intensive care unit patients with endotracheal intubation. Methods Selected 120 pulmonary infection in the surgical intensive care unit with endotracheal intubation from August 2012 to February 2014 in our hospital, the incidence of pulmonary infection and clinical data were to investigate; the pathogens were isolated in the pulmonary infection patients and were given the six kinds of drugs sensitivity analysis. Results There were 43 cases of pulmonary infection, the rate was 35.8%, 4 cases were died. Multiple multivariate conditional logistic regression model showed that age, catheterization, vascular catheter, the joint use of antibiotics were the major independent risk factors of pulmonary infection and there were 43 cases were isolated pathogens included 28 cases were Gram-negative bacteria, 11 cases were Gram-positive bacteria, 4 cases were fungi. The Gram-negative bacteria to cefuroxime, levofloxacin, cefazolin sensitivity rates were relatively low. Conclusion The pulmonary infection in the surgical intensive care unit with endotracheal intubation is relatively high, the prognosis is relatively poor and the mostly bacteria is Gramnegative bacteria, we should actively reasonable choice the rational antibiotics based on susceptibility circumstances.