摘要
目的了解重型颅脑损伤行气管切开后肺部感染患者下呼吸道痰液标本与护士留取标本洗手后手表标本主要分离病原菌的分布及相关性。方法收集于本院进行治疗的97例重型颅脑损伤气管切开后肺部感染患者的下呼吸道痰液标本及护士留取标本洗手后的手表标本,送微生物实验室分离培养病原菌并进行细菌鉴定,鉴定结果用WHONET5.4软件进行统计分析。结果共收集388份标本,其中痰液标本194份,护士手表标本194份。共分离得到病原菌633株,其中革兰阴性菌(G-菌)452株(71.41%),革兰阳性(G+)菌134株(21.17%),真菌47株(7.42%)。引起下呼吸道感染所占比例排前5位的G-菌依次为铜绿假单胞菌(12.16%)、鲍曼不动杆菌(9.63%)、肺炎克雷伯菌(7.10%)、嗜麦芽窄食单胞菌(5.21%)、大肠埃希菌(4.89%);主要G+菌为凝固酶阴性葡萄球菌(6.79%)、金黄色葡萄球菌(2.36%);真菌主要是白假丝酵母菌(4.24%)。护士手表分离细菌所占比例排前5位的G-菌依次是铜绿假单胞菌(6.79%)、鲍曼不动杆菌(5.84%)、大肠埃希菌(4.91%)、肺炎克雷佰菌(3.94%)、嗜麦芽窄食单胞菌(3.79%);主要G+菌主要是凝固酶阴性葡萄球菌(10.74%)、金黄色葡萄球菌(2.36%);真菌主要是白假丝酵母菌(3.00%)。结论重型颅脑损伤气管切开后肺部感染患者,存在交叉感染的危险因素,应强化护士手卫生管理和无菌技术操作规程的遵守。
Objective To investigate the distribution of pathogens isolated from lower respiratory tract sputum samples of trach‐eotomy patients who suffered from severe craniocerebral injury and nurses′hands surface samples ,and analyze the correlation be‐tween them .Methods Lower respiratory tract sputum samples of 97 tracheotomy patients suffered from severe craniocerebral inju‐ry and hands surface samples from nurses who just washed their hands after the sample collection were collected .Then the samples were sent to the microbiological lab for pathogen isolation and identification ,the results were statistically analyzed by using WHO‐NET5.4software.Results 388sampleswerecollectedaltogether,including194sputumsamplesand194nurses′handssurface samples .633 pathogens were isolated altogether ,including 452 strains of G- bacteria （71 .41% ） ,134 strains of G＋ bacteria （21 .17% ） and 47 strains of fungi（7 .42% ） .The top five species of G- bacteria which took the largest proportion and caused the lower respiratory tract infection were Peudomonas aeruginosa（12 .16% ） ,Acinetobacter baumannii（9 .63% ） ,Klebsiella pneumoniae bacteria（7 .10% ） ,Stenotrophomonas maltophilia（5 .21% ） ,Escherichia coli（4 .89% ）;the primary species of G＋ bacteria were coag‐ulase negative staphylococcus（6 .79% ） ,Staphylococcus aureus（2 .36% ）;the primary fungus was Monilia albicans（4 .24% ） .The top five G- bacteria species which took the largest proportion and isolated from hands surface samples were Pseudomonas aeruginosa （6 .79% ） ,Acinetobacter baumannii（5 .84% ） ,Escherichia coli（4 .91% ） ,Klebsiella pneumoniae（3 .94% ） ,Stenotrophomonas malto‐philia（3 .79% ）;the primary species of G＋ bacteria were coagulase negative staphylococcus （9 .63% ） ,Staphylococcus aureus （2 .36% ） .The primary fungus was Monilia albicans（3 .00% ） .Conclusion Tracheotomy patients who suffered from severe cranio‐cerebral injury with lower respiratory infection are very possible to have cross‐infection ,sanitary management of nurses′hands asep‐tic manipulation procedures should be strengthened .
出处
《国际检验医学杂志》
CAS
2015年第17期2521-2523,共3页
International Journal of Laboratory Medicine
关键词
气管切开术
下呼吸道感染
手表面
病原体
tracheotomy
lower respiratory infection
hands surface
pathogens
