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目的研究该院呼吸科重症监护病区(ICU)医院获得性下呼吸道感染病原菌分布及耐药,为临床医生提供防治依据。方法对住院时间>48 h的患者咳痰,气管插管吸引痰标本,涂片、培养及药敏试验。结果ICU病区下呼吸道感染细胞分离率为75%,其中革兰阴性杆菌85.0%,革兰阳性球菌4.6%。革兰阴性杆菌中,铜绿假单胞菌占32.3%,鲍曼氏不动杆菌占12.4%。药敏实验结果显示革兰阴性杆菌对头孢哌酮/舒巴坦,亚胺培南,哌拉西林/他唑巴坦和左旋氧氟沙星敏感性较高,铜绿假单胞菌对亚胺培南耐药率有明显增加趋势。结论铜绿假单胞菌、不动杆菌等革兰阴性杆菌是该院呼吸病房ICU病区院内获得性下呼吸道感染最主要的致病菌。
Objective To study the distribution and drug resistance of pathogenic bacteria in hospital acquired respiratory tract infection in intensive care unit (ICU) of the hospital and provide the basis for prevention and treatment for clinicians. Methods The sputum samples of sputum from patients who were hospitalized for> 48 h, sputum samples from tracheal intubation, smear, culture and drug sensitivity test were collected. Results The isolation rate of lower respiratory tract infection in ICU was 75%, of which 85.0% were Gram-negative bacilli and 4.6% were Gram-positive cocci. Among gram-negative bacilli, Pseudomonas aeruginosa accounted for 32.3% and Acinetobacter baumannii accounted for 12.4%. Susceptibility test results showed that Gram-negative bacilli were more susceptible to cefoperazone / sulbactam, imipenem, piperacillin / tazobactam and levofloxacin, and Pseudomonas aeruginosa to imine Peipei resistant rate has increased significantly. Conclusions Gram-negative bacilli such as Pseudomonas aeruginosa and Acinetobacter are the most important pathogenic bacteria in hospital-acquired lower respiratory tract infection in intensive care units of ICU in this hospital.