摘要
目的研究急诊患者使用呼吸机出现下呼吸道感染的病原菌分布及耐药性,为降低下呼吸道感染率提供依据。方法选择2013年9月-2014年7月在医院急诊使用呼吸机的135例患者,进行呼吸道标本采集、细菌培养鉴定及药物敏感性试验,使用M-H和流感嗜血菌培养基培养,细菌鉴定使用VITEK-32AMS全自动细菌鉴定仪。结果 135例患者发生下呼吸道感染43例,感染率为31.85%;感染患者共分离出病原菌68株,其中革兰阴性菌占67.64%,革兰阳性菌占16.18%,真菌占16.18%;革兰阴性菌中大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌对氨苄西林的耐药率最高,分别为90.00%、91.67%、88.89%、85.71%,革兰阳性菌中表皮葡萄球菌、金黄色葡萄球菌对青霉素的耐药率最高,均为100.00%。结论下呼吸道感染患者分离的病原菌中,革兰阴性菌所占比例最高,革兰阳性菌和真菌感染也占有一定的比例,不同类型的病原菌的耐药性不同。
OBJECTIVE To study the distribution and drug resistance of pathogens causing lower respiratory tract infections in the emergency patients using ventilators so as to reduce the incidence of the lower respiratory tract in‐fections .METHODS A total of 135 patients who were treated with ventilators in the emergency department from Sep 2013 to Jul 2014 were enrolled in the study .The respiratory tract specimens were collected for bacterial cul‐ture and identification ,the drug susceptibility testing was performed ,the M‐H and Haemophilus influenzae media were employed for the bacterial culture .RESULTS Of the 135 patients ,43 had the lower respiratory tract in‐fections ,with the infection rate of 31 .85% .Totally 68 strains of pathogens were isolated from the patients with infections ,of which 67 .64% were gram‐negative bacteria ,16 .18% were gram‐positive bacteria ,and 16 .18%were fungi .Among the gram‐negative bacteria ,the drug resistance rates of Escherichiacoli ,Pseudomonas aerug‐inosa ,Klebsiella pneumoniae ,and Acinetobacter baumannii to ampicillin were 90 .00% ,91 .67% ,88 .89% ,and 85 .71% ,respectively .Among the gram‐positive bacteria ,the drug resistance rates of Staphylococcus epidermi‐dis and Staphylococcus aureus to penicillin were 100 .00% .CONCLUSION The gram‐negative bacteria are domi‐nant among the pathogens causing the lower respiratory tract infections ,and the gram‐positive bacteria and fungi also occupy a certain proportion .The pathogens vary in the drug resistance .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第20期4607-4609,共3页
Chinese Journal of Nosocomiology
基金
国家临床重点专科基金资助项目(国卫办医函[2013]544)
上海市基金资助项目(10JC1412500)
关键词
急诊
呼吸机
下呼吸道感染
病原学
耐药性
Emergency department
Ventilator
Lower respiratory tract infection
Etiology
Drug resistance
