PICU肺部感染45例次调查分析

Clinical Analysis of 45 Cases of Pneumonia in PICU

目的:探讨儿童医院儿科监护室(PICU)肺部感染的情况。方法:调查我院和广州市儿童医院1999年10月-2003年4月ICU病房住院患儿45例次药敏及临床资料相关因素。结果:痰培养中革兰氏阴性杆菌检出率为64％(29/45),致病性球菌检出率为16％(7/45),真菌检出率为11％(5/45),厌氧菌检出率为9％(4/45),且对大部分抗生素耐药,肺部感染与年龄、基础疾病、住院时间、呼吸机使用时间及多种侵入性操作密切相关。本组肺部感染80％(36/45)发生在婴儿,33％(15/45)发生在先天性畸形术后患儿,64％(29/45)发生在住院超过2周的患儿;84％(38/45)发生在呼吸机连续使用在1周以上。结论:PICU病房肺部感染以革兰氏阴性杆菌为主,且耐药明显增高,使感染治疗十分困难,应高度重视及加强预防控制。

Objective: To investigate the causes of pneumonia in PICU of children's hospital. Methods: The antibiotics sensitivity of infecting bacteria and related clinical data of 45 cases of pneumonia from Guangzhou children hospital from October 1999 to April 2003 were investigated. Results: The check-up ratio of G-bacilli from sputum culture is 64% (29/45), and pathogenic coccus 16%(7/45), fungus 11%(5/45), anaerobic bacteria 9%(4/45), and they are resistant to most of antibiotics. The occurrence pneumonia was closely related to age, basic diseases, time of hospitalizing and resistant mechanical ventilation and kinds of invading operations. 80%(36/45) of pneumonia happened in infants, 33%(15/ 45) after operative correcting congenital deformity, 64%(29/45) in those hospitalized longer than two weeks, 84%(38/45) in those who were ventilated longer than one week. Conclusion: Pneumonia in PICU is mainly caused by G-bacilli which are resisted to antibiotics obviously. This makes it very hard to cure the infection.