论文部分内容阅读
目的探讨神经外科重型颅脑损伤患者术后继发肺部感染鲍曼不动杆菌的危险因素和耐药状况,为临床预防和治疗提供依据。方法以2014年1月—2016年1月黄石市第五医院神经外科收治的55例重型颅脑损伤患者继发肺部感染鲍曼不动杆菌患者为观察组,同时选取55例同期收治的脑部术后继发肺部感染非鲍曼不动杆菌患者为对照组,调查相关危险因素,并采用纸片扩散法测定菌株对抗菌药物的敏感性,数据采用采用SPSS 20.0软件进行统计学分析。结果低蛋白血症入院时GCS评分(≤8分)、ICU住院时间(>7 d)、使用碳青霉烯类和糖皮质激素及混合感染是重型颅脑损伤患者术后继发肺部感染鲍曼不动杆菌的危险因素。药敏结果显示,鲍曼不动杆菌对头孢哌酮钠/舒巴坦钠的敏感率最高,为78.18%,其次阿米卡星,敏感率为54.55%,头孢他啶和氨曲南的敏感率均小于10%。结论重型颅脑损伤患者肺部感染鲍曼不动杆菌的危险因素较多。鲍曼不动杆菌多重耐药严重,头孢哌酮钠/舒巴坦钠仍是敏感性最高的药物,其次是阿米卡星和亚胺培南,宜根据药敏试验结果选用。
Objective To investigate the risk factors and drug resistance of Acinetobacter baumannii in patients with severe craniocerebral injury after neurosurgery and provide basis for clinical prevention and treatment. Methods From January 2014 to January 2016, 55 patients with severe craniocerebral injury who were admitted to Department of Neurosurgery, the Fifth Hospital of Huangshi City, were randomly divided into observation group and control group. Fifty-five consecutive patients with Acinetobacter baumannii infection were selected as the observation group. The patients with non-Acinetobacter baumannii after secondary pulmonary infection were selected as the control group, the relevant risk factors were investigated, and the susceptibility of the strains to antimicrobial agents was determined by disk diffusion method. The data were analyzed by SPSS 20.0 software. Results Hypoproteinemia was associated with GCS score (≤8), ICU stay (> 7 days), carbapenems and glucocorticoid and mixed infection were the main cause of secondary pulmonary infection in patients with severe craniocerebral injury Acinetobacter baumannii risk factors. Susceptibility of Acinetobacter baumannii to cefoperazone sodium / sulbactam sodium was the highest (78.18%), followed by amikacin (54.55%), and ceftazidime and aztreonam were less than 10% . Conclusion There are more risk factors for pulmonary infection of Acinetobacter baumannii in patients with severe craniocerebral injury. Acinetobacter baumannii multi-drug resistance is serious, cefoperazone sodium / sulbactam sodium is still the most sensitive drug, followed by amikacin and imipenem, should be based on drug susceptibility test results.