气管切开术；病原菌；抗生素；痰液培养；药敏试验_

颅脑外科重症患者气管切开后下呼吸道感染病原菌及药敏分析

http://www.100md.com 《汕头大学医学院学报》 2006年第2期

气管切开术；病原菌；抗生素；痰液培养；药敏试验,,]气管切开术；病原菌；抗生素；痰液培养；药敏试验,1材料与方法,2结果,3讨论,参考文献

     [摘要]目的：探讨颅脑外科重症患者气管切开后下呼吸道感染病原菌的情况及其耐药性，为临床经验性用药提供帮助。方法：用VITEK_AMS微生物自动鉴定仪对气管切开术后患者的痰液进行培养及药敏试验。结果：316份痰标本中检出细菌278株，真菌34株；单一感染288株，混合感染24株；以革兰阴性杆菌为主(654%)，其次为革兰阳性球菌(231%)和真菌(109%)。革兰阴性杆菌以肺炎克雷伯菌居首位(154%),革兰阳性球菌以金黄色葡萄球菌占优势(135%),真菌主要为白色假丝酵母菌(96%)。药敏试验结果示，革兰阴性杆菌对亚胺培南高度敏感，对氨苄西林、庆大霉素高度耐药，葡萄球菌属对呋喃妥因、利福平敏感率较高，未发现耐万古霉素的革兰阳性球菌。结论：颅脑外科重症患者气管切开后下呼吸道感染的病原菌以革兰阴性杆菌为主，革兰阳性球菌感染以金黄色葡萄球菌为主，临床上应根据菌种和药敏试验结果合理选用抗生素。

    [关键词]气管切开术；病原菌；抗生素；痰液培养；药敏试验

    The Distribution and Drug Resistance Analysis of Pathogen from Cranial Neurosur_gical Patients with Lower Respiratory Tract Infection after Tracheotomy

    SHENG Chu_hua, GU Hong_ni, CHEN Lin_xing, QIU Xiao_hua

    (Department of Clinical Laboratory, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041，China)

    [Abstract]Objective：To investigate the distribution and drug resistance of pathogen from cranial neuro surgical patients with lower respiratory tract infection after tracheotomy. Methods: The pathogenic bacteria in patients sputum from patients with lower respiratory tract infection after tracheotomy were strictly identified and analysed by VITEK_AMS automatic microorganism analyser. Results：The strains of bacterial species(278)and funni(34)from 316 specimens were isolated. 288 strains were infected by one kind of bacteria and 24 strains were infected by two kinds of bacteria. Among the pathogen, gram_negative bacilli were about 654% and Klebsiella pneumoniae(154%)was the most predominant, gram_positive coccobacteria were about 231% and Staphylococcus aureus(135%)was the most predominant, funni were about 109% and C.albicans(96%)was the most predominant. The drug sensitivity test showed that the ratio of drug resistance of bacteria isolated from sputum was high ......

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