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目的研究急性有机磷农药中毒伴呼吸衰竭患者在机械通气治疗时医院内肺部感染致病菌的细菌学情况。方法对68例急性有机磷农药中毒伴呼吸衰竭患者在机械通气治疗48 h后,采用一次性无菌吸痰管经气管插管采集下呼吸道分泌物,作细菌培养、药敏及定量分析。结果下呼吸道分泌物68份,28份细菌培养阳性。分离菌株73株,革兰阴性杆菌53株,占72.6%,革兰阳性球菌9株,占12.30%;真菌11株。结论急性有机磷农药中毒呼吸衰竭患者机械通气治疗时易并发院内肺部感染。应进行病原学监测,指导抗生素的正确使用,提高抢救成功率。
Objective To study the bacteriological characteristics of pulmonary pathogens in patients with acute organophosphorus pesticide poisoning and respiratory failure during mechanical ventilation. Methods Sixty-eight patients with acute organophosphorus pesticide poisoning and respiratory failure were treated with mechanical ventilation for 48 hours. The lower respiratory tract secretions were collected via a tracheal intubation using a disposable sterile suction tube for bacterial culture, drug susceptibility and quantitative analysis. Results Lower respiratory secretions 68, 28 were positive for bacterial culture. 73 isolates, 53 Gram-negative bacilli, accounting for 72.6%, 9 Gram-positive cocci, accounting for 12.30%, and 11 fungi. Conclusion Acute organophosphorus pesticide poisoning respiratory failure patients with mechanical ventilation when complicated by pulmonary nosocomial infection. Etiological monitoring should be conducted to guide the correct use of antibiotics to improve the success rate of rescue.