本文選題：重型顱腦外傷 + 下呼吸道感染　； 參考：《中國消毒學雜志》2017年05期

【摘要】：目的了解重型顱腦外傷患者下呼吸道感染病原菌種類分布及其耐藥性,為臨床合理用藥和醫(yī)院感染控制提供科學依據(jù)。方法采用細菌分離鑒定和藥敏試驗方法,對某醫(yī)院神經外科重型顱腦外傷合并下呼吸道感染患者送檢病原學標本進行檢測與分析。結果從186例患者送檢的痰標本中,共檢出病原菌陽性107例,陽性率為57.5%。共分離病原菌138株,其中革蘭陰性桿菌115株,占83.3%;革蘭陽性球菌和真菌分別占12.3%和4.4%。分離率居前3位的菌種分別為銅綠假單胞菌、鮑曼不動桿菌和肺炎克雷伯菌。分離的病原菌普遍耐藥,分離率居首位的銅綠假單胞菌對亞胺培南的耐藥率為36.1%,對氨基糖苷類抗菌藥物保持高敏感性。結論重型顱腦外傷下呼吸道感染患者病原菌以革蘭陰性桿菌為主,多重耐藥菌檢出率高,應加強抗菌藥物應用的管控。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogens of lower respiratory tract infection in patients with severe craniocerebral trauma, and to provide scientific basis for rational drug use and nosocomial infection control.Methods bacterial isolation and drug sensitivity test were used to detect and analyze the pathogens of patients with severe craniocerebral trauma complicated with lower respiratory tract infection in a hospital.Results 107 of 186 sputum samples were positive, the positive rate was 57.5%.A total of 138 strains of pathogenic bacteria were isolated, among which 115 strains were Gram-negative bacilli (83.3%), while gram-positive cocci and fungi accounted for 12.3% and 4.4%, respectively.Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae were the three most isolated bacteria.Pseudomonas aeruginosa with the highest isolation rate was 36.1% to imipenem and highly sensitive to aminoglycoside antibiotics.Conclusion Gram-negative bacilli are the main pathogens in patients with lower respiratory tract infection after severe craniocerebral injury, and the detection rate of multidrug resistant bacteria is high. The control of antimicrobial application should be strengthened.
【作者單位】： 浙江省常山縣人民醫(yī)院;
【分類號】：R56

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