摘要
目的探讨颅脑外伤后肺部感染患者病原菌的耐药性与抗菌药物使用之间的关系,为临床合理使用抗菌药物提供参考。方法对137例重型颅脑外伤后合并肺部感染患者的临床资料进行回顾性分析,统计分析病原菌的耐药率与抗菌药物用药总量之间的关系。结果颅脑外伤后肺部感染患者中病原菌以革兰阴性杆菌为主,占64.62%,其次分别为革兰阴性球菌、真菌和革兰阳性球菌;病原菌对青霉素、氨苄西林和头孢唑林的耐药率与其用药总量呈负相关(r值分别为-0.82、-0.70和-0.87,P<0.05);对头孢他啶、头孢曲松、头孢哌酮的耐药率与其用药总量呈正相关(r值分别为0.75、0.81和0.92,P<0.05);对庆大霉素、环丙沙星和阿米卡星的耐药率与其用药总量呈无相关(r值分别为0.42、0.47和0.51,P>0.05)。结论抗菌药物应用构成比的变化可改变重型颅脑外伤后肺部感染患者病原菌的耐药性,临床医师应根据药敏结果合理选用抗菌药物。
OBJECTIVE To investigate the relationship between drug resistance of pathogens and antibiotics in patients with lung infection after traumatic brain injury and offer clinical reference for the use of antibiotics. METHODS The clinical data of 137 patients of severe head trauma with pulmonary infection were retrospectively analyzed, then a statistical analysis was taken on the relationship between the drug resistance of pathogens and total dosage of antibiotics. RESULTS The most common pathogen was Gram-negative bacilli which accounted for 64.62%, followed by Gram-negative coccus, fungi and Gram-positive coccus. In this group, the resistance rates of the pathogens to penicillin, ampicillin and cefazolin had a negative correlation with total drug （r=- 0. 82, -0.70 and -0.87, P〈0.05）; and to ceftazidime, ceftriaxone, cefoperazone, the resistance rate of pathogens had a positive correlation with total drug （r=0. 75,0. 81 and 0.92, P〈0. 05）3 but to gentamicin, eiprofloxacin and amikacin, there had no correlation （r= 0. 42,0. 47 and 0. 51, P〉0. 05）. CONCLUSION The change of composition ratio of application of antibiotics can change the drug resistance of pathogens in patients with lung infection after traumatic brain injury. The clinicians should select antibiotics reasonably based on the antimicrobial susceptibility results.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2010年第22期3615-3617,共3页
Chinese Journal of Nosocomiology
关键词
颅脑外伤
肺部感染
病原菌
耐药性
抗菌药物
相关性
Brain trauma
Lung infection
Pathogen
Drug resistance
Antibiotics
Correlation
