本文關(guān)鍵詞： 重型顱腦外傷 下呼吸道感染 病原菌　出處：《中華醫(yī)院感染學(xué)雜志》2016年01期 　論文類型：期刊論文

【摘要】：目的探討重型顱腦外傷氣管切開患者下呼吸道感染病原菌特點(diǎn)及防治措施,為臨床診治提供參考。方法選取2014年1-12月32例醫(yī)院腦外科重型顱腦外傷并實(shí)施氣管切開并發(fā)生下呼吸道感染患者,對其實(shí)施病原學(xué)檢測,分析患者感染病原菌分布及耐藥率,并提出感染控制措施。結(jié)果 32例患者共分離出51株病原菌,其中革蘭陰性菌35株占68.63%,以肺炎克雷伯菌和鮑氏不動桿菌為主,革蘭陽性菌16株占31.37%,以金黃色葡萄球菌為主;肺炎克雷伯菌、鮑氏不動桿菌對亞胺培南耐藥率為0,對妥布霉素、羧芐西林等藥物耐藥率較高;金黃色葡萄球菌、溶血葡萄球菌對萬古霉素耐藥率為0,對慶大霉素等藥耐藥率較高。結(jié)論重型顱腦外傷氣管切開患者下呼吸道感染病原菌較多,耐藥機(jī)制復(fù)雜,臨床需加強(qiáng)護(hù)理,合理使用抗菌藥物、強(qiáng)化消毒隔離,以降低感染率。
[Abstract]:Objective to investigate the pathogenic bacteria characteristics of lower respiratory tract infection in patients with severe craniocerebral trauma tracheotomy, and to investigate the preventive and therapeutic measures. Methods 32 patients with severe craniocerebral injury in the department of brain surgery in hospital from 2014 to December 2001 were selected and treated with tracheotomy and lower respiratory tract infection. The pathogens were detected and the distribution of pathogenic bacteria and drug resistance rate were analyzed. Results 51 strains of pathogenic bacteria were isolated from 32 patients, of which 35 strains were Gram-negative bacteria, mainly Klebsiella pneumoniae and Acinetobacter baumannii, 16 Gram-positive bacteria accounted for 31.37 and Staphylococcus aureus. Klebsiella pneumoniae, Acinetobacter baumannii resistance rate to imipenem is 0, tobramycin, Carbenicillin and other drugs resistance rate is higher; Staphylococcus aureus, Staphylococcus aureus, Staphylococcus aureus, Staphylococcus aureus, The resistance rate of Staphylococcus haemolyticus to vancomycin was 0, and to gentamicin was higher. Conclusion there are more pathogenic bacteria of lower respiratory tract infection in patients with severe craniocerebral trauma tracheotomy, and the mechanism of drug resistance is complicated. Rational use of antimicrobial agents, strengthening disinfection and isolation, in order to reduce the infection rate.
【作者單位】： 浙江省舟山醫(yī)院神經(jīng)外科;浙江省舟山醫(yī)院感染科;浙江省舟山醫(yī)院院感科;浙江省舟山醫(yī)院醫(yī)保辦;
【基金】：浙江省衛(wèi)生廳基金資助項(xiàng)目(2013KYB273)
【分類號】：R446.5

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