腹腔手术后医院内下呼吸道感染分析.pdfVIP

446 Chinese Joumal of Modem 0~rative Su职ery．Dec．2007．Vo1．1 I．No．6 · 临 床 论 著 · [文章编号]1009—2188(2007)06一O446—03 腹腔手术后医院内下呼吸道感染分析 张建凯，刘迪凡，吴晓波 (湖南省华容县人民医院普外科，华容414200) [摘要] 目的 分析腹腔手术后患者医院内下呼吸道感染的常见病原菌及药物敏感情况。 方法 回顾性分析2002年1月～2007年1月246例腹腔手术后下呼吸道感染患者的痰菌培养结果。 结果 246例住院患者分离出261株病原菌，其中革兰氏阴性杆菌183株(70．I％)，主要为铜绿假单胞 菌、流感嗜血杆菌、不动杆菌、副流感嗜血杆菌和克雷伯菌；革兰阳性球菌6o株(23．0％)，主要为表皮葡 萄球菌、肺炎链球菌及金黄色葡萄球；真菌l8株(6．8％)。铜绿假单胞菌、不动杆菌、克雷伯菌对美洛培 南、舒普深、头孢吡肟敏感；葡萄球菌对万古霉素均敏感；肺炎链球菌对美洛培南、左氟沙星敏感率高，对 青霉素大部分耐药。 结论 下呼吸道感染以革兰氏阴性杆菌感染为主，且常见病原菌耐药性明显，应 根据药敏试验规范使用抗生素，减少耐药菌的产生。 [关键词] 呼吸道感染；抗菌药； 药物敏感性试验 [中图分类号]R656 [文献标识码]B Analysis of Nosocomial Lower Respiratory Tract Infection after Abdominal Operation ZHANG．， n—kai， LIU Oi-fan，WU Xiao—bo (Department ofGeneral Surgery，People tlospaat ofHuarong，Huarong 414200，Hu— rlart，China) Abstract： Objective To investigate the pathogenic bacteria distribution and susceptibility of nosocomi— al lower respiratory tract infection(NLRTI)in patients who underwent abdominal operation Method From January 2002 to January 2007，246 NLRTI patients after abdominal operation received sputum or secretion eul— ture． Results A total of 261 clinical isolates were collected，including 183(70．1％)strains of gram nega- tive bacilli，60(23．0％)strains of gram positive cocci and I8(6．8％)strains of funs4．The major pathogens in gram negative bacilli were Pseudomonas aeruginosa，Haemophilus influenzae，Aeinetobaeter，Haemophilus parainfluenzae and Klebsiella．The key pathogens in gram positive cocci were St印hyloeoeeus epidermidis， Streptococcus pneumoniae and Staphylococcus aureus．Pseudomonas aeruginosa，Aeinetobaeter and Klebsiella were susceptible to meropenem，sulperazone and eefepime．In gram positive cocci，Staphylococci were all SUS— eeptible to vancomycin，Streptococcus pneumoniae were highly susceptible to meropenem and levofloxacin， while were hi【ghly resist