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目的:通过对ICU院感脓毒症患者病原菌检测、耐药性及预后分析,为临床合理用药和控制院感提供科学依据。方法:回顾性分析206例ICU院感脓毒症患者的临床资料。结果:感染者以有基础性疾病的老年人、长期用药、病情危重、接受侵入性检查与治疗的患者居多;感染部位以呼吸道、泌尿道、导管相关性疾病感染为最多见;共分离病原菌394株,常见病原菌主要是G-杆菌190株(铜绿假单胞菌为主),其次是G+球菌118株(金黄色葡萄球菌为主)、真菌86株(白色假丝酵母菌为主);常见病原菌耐药性较高;预后主要影响因素是重视并加强临床护理及心血管、呼吸、泌尿、血液、消化、神经等多系统、多脏器功能障碍等。经临床综合治疗,采取有效预防和护理措施,改善预后。结论:由于ICU院感脓毒症患者常见病原菌耐药性较高,应根据药敏试验结果合理用药;有效预防和护理措施及心血管、呼吸、泌尿、血液、消化、神经等多系统、多脏器功能障碍等是影响其预后主要因素,临床应积极防治并加强护理,改善预后。
OBJECTIVE: To provide a scientific basis for clinical rational use of drugs and control of nosocomial infection through pathogenic bacteria detection, drug resistance and prognosis analysis of ICU nosocomial sepsis patients. Methods: A retrospective analysis of 206 patients with ICU nosocomial sepsis clinical data. Results: In the elderly with the underlying diseases, long-term medication, critically ill patients and patients who underwent invasive examination and treatment were mostly infected. Infection sites were most common with respiratory, urinary and catheter-related diseases. Pathogenic bacteria 394 Strain, the common pathogens are G-bacteria 190 (Pseudomonas aeruginosa mainly), followed by G + cocci 118 strains (Staphylococcus aureus mainly), fungi 86 (Candida albicans); common Pathogen resistance is high; the main prognostic factor is to pay attention to and strengthen clinical care and cardiovascular, respiratory, urinary, blood, digestive, nervous and other multiple systems, multiple organ dysfunction. After clinical comprehensive treatment, take effective preventive and nursing measures to improve the prognosis. Conclusion: Due to the high drug resistance of common pathogenic bacteria in sepsis patients with ICU sepsis, rational drug use should be based on the results of drug sensitivity test. Effective prevention and care measures and cardiovascular, respiratory, urinary, blood, digestive, Organ dysfunction is the main factor affecting their prognosis, clinical should actively prevent and strengthen care and improve prognosis.