NICU气管切开患者下呼吸道鲍曼不动杆菌感染临床分析与护理干预.docVIP

NICU气管切开患者下呼吸道鲍曼不动杆菌感染临床分析与护理干预 　　[摘要] 目的:探讨NICU病房内鲍曼不动杆菌的感染情况、耐药性、相关因素及正确的护理干预措施。方法:针对本院NICU 2008年11月～2009年12月气管切开患者鲍曼不动杆菌导致的下呼吸道感染进行回顾性分析,采用K-B法进行药敏实验,按NCCLS标准判断细菌耐药性。结果:268例痰标本中检出鲍曼不动杆菌77株,达到28.73%。对头孢他啶、头孢噻肟、头孢唑啉、氨苄西林的耐药比例均高于70%,对亚胺培南、头孢哌酮/舒巴坦比较敏感。鲍曼不动杆菌耐药性、免疫功能低下、机械通气、鼻胃管留置以及广谱抗生素的应用,为鲍曼不动杆菌感染的主要原因。结论:医院内获得性鲍曼不动杆菌对多种抗生素的耐药性高,且耐药率增加较快,临床应合理使用抗生素,以提高疗效和减缓耐药株的产生。应实施有效的消毒隔离措施,加强医院感染知识学习,加强医护人员的无菌操作。 　　[关键词] 神经外科重症监护病房;痰液;细菌培养;药敏 ;鲍曼不动杆菌;下呼吸道感染;护理干预 　　[中图分类号] R473.74 [文献标识码]C [文章编号]1674-4721(2010)04(a)-082-02 　　 　　Analysis and nursing intervention of Acinetobacter baumannii isolated from lower respiratory tract in NICU patients with tracheotomy 　　ZHOU Fanghong,ZOU Dongmei,HUANG Jinli,CHEN Fang,WU Min 　　(Heilongjiang Province Daqing Longnan Hospital neurosurgery(Qiqihar Medical College Fifth Affiliated Hospital), Daqing163453, China) 　　[Abstract] Objective:To comprehend characteristics and risk factors of lower respiratory tract infection with acinetobacter baumannii after tracheotomy and nursing intervention. Methods: 246 sputum samples from lower respiratory tract were collected from which 77 stains of acinetobacter baumannii were obtained.the clinical characteristics and nursing intervention were analyzed retrospectively. Results: The prevalence of acinetobacter baumannii was 28.73%,Drug sensitivity show that acinetobacter baumannii was markedly increasing and susceptible to imipenem and cefoperazone/sulbactam. Conclusion: To control infection effectively , reasonnable application of antibiotics and sterilizing measures must be carry out. 　　[Key words] Lower respiratory tract infection;Pathogenic bacteria;Antibiotic Resistance;Sputum culture;Drug sensitive test; Respiratory tract infections;Nursing intervention 　　 　　鲍曼不动杆菌为革兰阴性需氧非发酵菌,是医院内获得性感染常见的条件致病菌,且其分离率与耐药性呈逐年上升的趋势。为了解鲍曼不动杆菌的分布特点、耐药现状,为临床及早、有效地控制感染,合理使用抗生素及制定应对护理措施,有效控制该病菌医院感染的发生和流行。本文对本院NICU 2008年12月～2009年11月医院内获得性鲍曼不动杆菌分布与耐药性进行回顾分析,并提出相应的预防及护理措施。现报道如下: 　　1 资料与方法 　　1.1 标本来源 　　全部标本来自本院NICU病房2008