重型颅脑外伤气管切开患者下呼吸道感染病原菌特点与预防

发布时间：2018-02-21 07:18

本文关键词： 重型颅脑外伤下呼吸道感染病原菌　出处：《中华医院感染学杂志》2016年01期 　论文类型：期刊论文

【摘要】：目的探讨重型颅脑外伤气管切开患者下呼吸道感染病原菌特点及防治措施,为临床诊治提供参考。方法选取2014年1-12月32例医院脑外科重型颅脑外伤并实施气管切开并发生下呼吸道感染患者,对其实施病原学检测,分析患者感染病原菌分布及耐药率,并提出感染控制措施。结果 32例患者共分离出51株病原菌,其中革兰阴性菌35株占68.63%,以肺炎克雷伯菌和鲍氏不动杆菌为主,革兰阳性菌16株占31.37%,以金黄色葡萄球菌为主;肺炎克雷伯菌、鲍氏不动杆菌对亚胺培南耐药率为0,对妥布霉素、羧苄西林等药物耐药率较高;金黄色葡萄球菌、溶血葡萄球菌对万古霉素耐药率为0,对庆大霉素等药耐药率较高。结论重型颅脑外伤气管切开患者下呼吸道感染病原菌较多,耐药机制复杂,临床需加强护理,合理使用抗菌药物、强化消毒隔离,以降低感染率。
[Abstract]:Objective to investigate the pathogenic bacteria characteristics of lower respiratory tract infection in patients with severe craniocerebral trauma tracheotomy, and to investigate the preventive and therapeutic measures. Methods 32 patients with severe craniocerebral injury in the department of brain surgery in hospital from 2014 to December 2001 were selected and treated with tracheotomy and lower respiratory tract infection. The pathogens were detected and the distribution of pathogenic bacteria and drug resistance rate were analyzed. Results 51 strains of pathogenic bacteria were isolated from 32 patients, of which 35 strains were Gram-negative bacteria, mainly Klebsiella pneumoniae and Acinetobacter baumannii, 16 Gram-positive bacteria accounted for 31.37 and Staphylococcus aureus. Klebsiella pneumoniae, Acinetobacter baumannii resistance rate to imipenem is 0, tobramycin, Carbenicillin and other drugs resistance rate is higher; Staphylococcus aureus, Staphylococcus aureus, Staphylococcus aureus, Staphylococcus aureus, The resistance rate of Staphylococcus haemolyticus to vancomycin was 0, and to gentamicin was higher. Conclusion there are more pathogenic bacteria of lower respiratory tract infection in patients with severe craniocerebral trauma tracheotomy, and the mechanism of drug resistance is complicated. Rational use of antimicrobial agents, strengthening disinfection and isolation, in order to reduce the infection rate.
【作者单位】：浙江省舟山医院神经外科;浙江省舟山医院感染科;浙江省舟山医院院感科;浙江省舟山医院医保办;
【基金】：浙江省卫生厅基金资助项目(2013KYB273)
【分类号】：R446.5

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