本文選題：腸桿菌科 + 肺炎��； 參考：《重慶醫(yī)學(xué)》2017年03期

【摘要】：目的回顧性分析呼吸機(jī)相關(guān)肺炎中革蘭陰性菌感染的情況及其處理策略,以期為預(yù)防和治療呼吸機(jī)相關(guān)性肺炎(VAP)提供參考。方法對(duì)146例因呼吸、神經(jīng)系統(tǒng)疾病,感染性疾病,創(chuàng)傷、手術(shù)、心肺復(fù)蘇等病因進(jìn)入ICU救治而發(fā)生革蘭陰性菌VAP患者進(jìn)行回顧性分析。經(jīng)口(鼻)氣管插管、氣管切開導(dǎo)管抽取痰液進(jìn)行細(xì)菌培養(yǎng)、分離和藥物敏感性試驗(yàn)。結(jié)果 146例患者均行經(jīng)口、鼻氣管插管或氣管切開行機(jī)械通氣48h以上,平均6d。其中早發(fā)性VAP(機(jī)械通氣小于或等于3d)34例,晚發(fā)性VAP(機(jī)械通氣大于3d)112例。細(xì)菌培養(yǎng)結(jié)果顯示,感染的細(xì)菌主要有鮑曼不動(dòng)桿菌38株,不動(dòng)桿菌其他屬11株,銅綠假單胞菌26株,肺炎克雷伯菌21株,大腸桿菌17株,陰溝腸桿菌7株,阪崎腸桿菌4株,司徒普羅威登菌4株,嗜麥芽單胞菌4株,棒狀桿菌3株,短黃桿菌3株,諾米勒諾菌2株,格利斯特2株,糞產(chǎn)堿菌1株,產(chǎn)氣桿菌1株。藥物敏感試驗(yàn)顯示,革蘭陰性菌對(duì)碳青霉烯類、第4代頭孢菌素、哌拉西林/他唑巴坦、喹諾酮類、氨基糖苷類敏感,但喹諾酮類、氨基糖苷類敏感度小于20%。結(jié)論革蘭陰性菌VAP是機(jī)械通氣過(guò)程中常見而嚴(yán)重的并發(fā)癥之一,其細(xì)菌耐藥發(fā)生率越來(lái)越高。
[Abstract]:Objective to analyze retrospectively the infection of gram-negative bacteria in ventilator-associated pneumonia (VAP) and its management strategy in order to provide reference for the prevention and treatment of ventilator-associated pneumonia (VAP). Methods 146 patients with Gram-negative bacteria VAP caused by respiratory, nervous system diseases, infectious diseases, trauma, surgery and cardiopulmonary resuscitation were retrospectively analyzed. Sputum was extracted from oral (nasal) tracheal intubation and tracheotomy for bacterial culture, isolation and drug sensitivity test. Results 146 patients were treated with nasal tracheal intubation or tracheotomy for more than 48 hours with an average of 6 days. There were 34 cases of premature VAP (mechanical ventilation < or equal to 3 days) and 112 cases of late onset VAP (mechanical ventilation > 3 days). The results of bacterial culture showed that there were 38 strains of Acinetobacter baumannii, 11 strains of Acinetobacter other genera, 26 strains of Pseudomonas aeruginosa, 21 strains of Klebsiella pneumoniae, 17 strains of Escherichia coli, 7 strains of Enterobacter cloacae and 4 strains of Enterobacter sakazakii. There were 4 strains of Stubbs, 4 strains of maltophilia, 3 strains of Corynebacterium, 3 strains of Xanthobacterium brevis, 2 strains of Normie Renaud, 2 strains of Glist, 1 strain of Alcaligenes faecalis and 1 strain of Aerobacterium. The drug sensitivity test showed that Gram-negative bacteria were sensitive to carbapenes, cephalosporins, piperacillin / tazobactam, quinolones and aminoglycosides, but the sensitivity of quinolones and aminoglycosides was less than 20g. Conclusion Gram-negative bacteria VAP is one of the common and serious complications during mechanical ventilation, and the incidence of bacterial resistance is increasing.
【作者單位】： 四川省內(nèi)江市中醫(yī)醫(yī)院ICU;
【分類號(hào)】：R563.1

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 于農(nóng);金欣;陳建魁;宋世平;尹秀云;;內(nèi)毒素血癥與革蘭陰性菌感染的關(guān)系[J];中國(guó)誤診學(xué)雜志;2008年13期

2 時(shí)勇;;血漿脂多糖檢測(cè)快速診斷革蘭陰性菌感染的研究[J];國(guó)際檢驗(yàn)醫(yī)學(xué)雜志;2013年12期

3 魏謀;唐娟;林惠梅;羅曉玲;周偉;;革蘭陰性菌感染新生兒血漿脂多糖測(cè)定臨床意義[J];中華實(shí)用診斷與治療雜志;2013年06期

4 鄒國(guó)英;任碧瓊;徐飛;劉豐偉;;革蘭陰性菌感染患者降鈣素原的測(cè)定[J];國(guó)際檢驗(yàn)醫(yī)學(xué)雜志;2010年05期

5 申翔;丁群;孫茜;王鵬華;y囋買，

本文編號(hào)：2085677