【摘要】 目的分析严重多发伤患者气管切开术后痰培养病原菌的分布、变迁及耐药。方法对该院创伤外科ICU病房2005年1月～2007年12月收治的210例多发伤气管切开术后的患者进行痰培养,分析病原菌的分布、变迁以及细菌耐药状况。结果93例患者痰培养阳性,病原菌分离率达44.3%;培养出病原菌122株,其中细菌114株,真菌8株;混合感染17例,混合感染率达18.3%。病原菌以鲍曼氏不动杆菌(33.6%)、金黄色葡萄球菌(22.1%)和铜绿假单胞菌(18.3%)为主。鲍曼氏不动杆菌和金黄色葡萄球菌检出率在逐年上升。革兰氏阴性杆菌主要对头孢哌酮/舒巴坦、亚胺培南、美洛培南敏感,革兰氏阳性球菌以金黄色葡萄球菌为主,对万古霉素和替考拉宁敏感。结论严重多发伤患者气管切开术后易发生肺部感染,痰培养的病原菌主要为革兰氏阴性杆菌,但革兰氏阳性球菌的检出率在逐年上升。检出病原菌对临床常用抗生素耐药率上升,且部分呈多重耐药。更多还原

【Abstract】 【Objective】To study the distribution and drug resistance of pathogens from sputum culture on patients with severe multiple injuries after tracheotomy in traumatic ICU. 【Method】Sputum culture was taken to analyze the distribution and drug resistance of pathogens from 210 patients with severe multiple injuries after tracheotomy during Jan 2005 and Dec 2007. 【Results】93 cases suffered from acquired respiratory infection, with the total infection rate of 44.3%. 122 lines of pathogens were found, including 114 lines of bacteria and 8 lines of fungi. 17 patients showed combined infection, with combined infection rate of 18.3%. The predominant pathogens were Acinetobacter baumannii (33.6%), Staphylococcus aureus (22.1%) and Pseudomonas aeruginosa (18.3%). The main sensitive antibiotics to Gram-negative bacteria were cefoperazone/sulbactam, imipenem, meropenem. Vancomycin and teicoplanin were sensitive to Staphylococcus aureus. 【Conclusion】Patients with severe multiple injuries after tracheotomy were prone to respiratory infection. The main pathogens were Gram-negative bacteria. Gram-positive bacteria increased year by year. They resisted to antibiotics at different degrees, some showed multi resistance.更多还原