384例ICU病房机械通气患者细菌感染及耐药研究.doc

384例ICU病房机械通气患者细菌感染及耐药研究【摘要】目的 探讨ICU病房机械通气患者细菌感染及耐药情况，为临床合理使用抗生素提供理论依据。方法 选取我院ICU病房2003年7月~2010年7月收治的384例机械通气患者的临床资料，分析患者的病原菌种类和耐药性。结果 感染患者313例，占81.51%，革兰氏阴性菌244株，占77.96%；革兰氏阳性菌69例，占22.04%，其中最常见致病菌为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯杆菌、大肠埃希菌和金黄色葡萄球菌。敏感试验多数细菌呈多重耐药。结论 应重视ICU患者病原菌分布，特别是ICU患者病房感染中鲍曼不动杆菌，铜绿假单胞菌的多重耐药，应引起临床重视，在临床工作中要加强耐药性监测，合理使用抗生素。 【关键词】ICU病房 机械通气 细菌感染 耐药性 中图分类号：R446.5文献标识码：A文章编号：1005-0515（2011）3-029-02 384 patients with mechanical ventilation ICU ward and drug resistance of bacteria Liang Bing (Baoshan City, Yunnan Province, People’s Hospital Critical Care Medicine, Baoshan 678000) 【Abstract】Objective To investigate the mechanical ventilation in ICU wards, and drug resistance in patients with bacterial infections, for clinical use of antibiotics to provide the theoretical basis. Methods ICU ward in our hospital in July 2003 ~ July 2010 384 cases were treated with mechanical ventilation in patients with clinical data of patients with pathogenic bacteria and drug resistance. Results 313 cases infected patients, accounting for 81.51%, Gram-negative bacteria 244, accounting for 77.96%; Gram-positive bacteria 69 cases, accounting for 22.04%, the most common pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa intracellular bacteria, Klebsiella pneumoniae, Escherichia coli and Staphylococcus aureus. Most sensitive test was multi-drug resistant bacteria. Conclusion ICU patients should pay attention to pathogenic bacteria, especially ICU ward patients with Acinetobacter baumannii infections, multidrug resistant Pseudomonas aeruginosa, should be paid attention, in clinical work to strengthen the monitoring of drug resistance and rational use of antibiotics . 【Key words】ICU ward mechanical ventilation bacterial infection drug resistance ICU患者免疫力较低，病情严重，加上广谱抗菌药物的普遍使用导致耐药菌株不断增加和病人接受侵袭性医疗器械操作的机会增加，致使感染的发生率明显高于普通病房。ICU病房机械通气患者肺部感染的发生率比较高，菌种的耐药性比较高[1]，可以出现多重耐药和多重菌感染，应该高度重视，合理应用抗生素和免疫抑制剂能减少不必要的诊疗操作，加强护理、操作等方面的管理，可以改善患者的预后，并降低感染发生率，本文重点介绍我院ICU病房机械通气患者感染