摘要
目的探讨颅脑外伤患者发生肺部感染的病原菌分布及药敏结果,为临床合理使用抗菌药物提供依据。方法对2002年1月-2012年8月收治的颅脑外伤合并肺部感染患者下呼吸道分离的病原菌进行培养,药敏试验采用纸片扩散法,按照美国临床实验室标准化委员会标准判断结果。结果 897例颅脑外伤患者有79例发生肺部感染,感染率为8.81%;分离79株病原菌,革兰阴性菌49株占62.03%,革兰阳性菌21株占26.58%,真菌9株占11.39%;多数病原菌对抗菌药物呈多药耐药性,对革兰阴性菌耐药率较低的有头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南,均<40.00%,对革兰阳性菌耐药率较低的药物有万古霉素、替考拉宁,均<5.00%。结论引起颅脑损伤并发肺部感染患者的病原菌耐药性严重,对多种抗菌药物耐药,革兰阴性菌感染比例增高,临床应加强病原菌培养及药敏监测,合理使用抗菌药物,采取有效措施减少感染发生。
OBJECTIVE To explore the distribution of pathogens causing pulmonary infections in the patients with traumatic brain injury and to analyze the result of drug susceptibility testing so as to provide basis for reasonable use of antibiotics. METHODS The bacterial culture was performed for the lower respiratory tracts of the traumatic brain injury patients complicated with pulmonary infections who were enrolled the hospital from Jan 2002 to Aug 2012, the drug susceptibility testing was carried out by disc diffusion method, and the result was determined according to the standard of Nationa Committee for Clinical Laboratory Standards of the America. RESULTS Of 897 patients with traumatic brain injury, the pulmonary infections occurred in 79 cases with the infection rate of 8.81%. Totally 79 strains of pathogens were isolated, including 49 （62.03 %） strains of gram-negative bacteria, 21 （26.58%） strains of gram-positive bacteria,and 9（11.39%） strains of fungi. The result of the drug susceptibility testing showed that most of the pathogens were multidrug-resistant, the drug rosistance rates of gram-negative bacteria to cefoperazone/sulbactam , piperacillin/tazobatam, and imipenem were less than 40.00 %, while the grampositive bacteria were highly sensitive to vancomycin, and teicoplanin with the drug resitance rates less than 5.00%. CONCLUSION The pathogens causing pulmonary infections in the traumatic brain injury patients are highly multidrug-resistant. The proportion of the patients with gram-negative bacteria infections is increasing, thus, it is necessary for the hospital to strengthen the bacterial culture and the monitoring of drug susceptibility, to reasonably use antibiotics ,and to take effective measures so as to reduce the incidence of infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第6期1447-1449,共3页
Chinese Journal of Nosocomiology
关键词
颅脑外伤
肺部感染
病原菌
耐药性
Traumatic brain injury
Pulmonary infection
Pathogen
Drug resistance
