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目的调查重症监护病房(ICU)应用人工气道进行机械通气的患者发生下呼吸道感染时的致病菌群分布及耐药性分析。方法对2004年9月~2006年6月在我院ICU住院3 d以上的129例发生下呼吸道感染的机械通气患者痰培养分离出的193株致病菌进行药敏试验。结果革兰阳性菌占9.5%。革兰阴性菌占78.8%,其中主要致病菌是不动杆菌属(32.9%)。药敏结果表明:所有革兰阴性菌对抗菌药物的耐药率呈上升趋势。结论引起机械通气患者下呼吸道感染的病原菌仍以革兰阴性菌为主,不动杆菌属、真菌检出率较高。为避免耐药率的升高,临床上合理使用抗菌药物至关重要。
Objective To investigate the distribution and drug resistance of pathogenic bacteria in patients with lower respiratory tract infection in intensive care unit (ICU) using artificial airway for mechanical ventilation. Methods Ninety-nine pathogenic bacteria isolated from sputum of mechanically ventilated patients with lower respiratory tract infection who were hospitalized for more than 3 days in our hospital from September 2004 to June 2006 were tested for susceptibility. The results of Gram-positive bacteria accounted for 9.5%. Gram-negative bacteria accounted for 78.8%, of which the main pathogen was Acinetobacter (32.9%). Susceptibility results show that: all Gram-negative bacteria antimicrobial resistance rates are on the rise. Conclusions Gram-negative bacteria are still the main pathogens causing lower respiratory tract infection in patients with mechanical ventilation. Acinetobacter and fungi are detected with higher detection rate. In order to avoid the rise of drug resistance, it is very important to use antibiotics in clinic rationally.