神经内科重症监护室肺部感染病原体分布及耐药性剖析.docVIP

神经内科重症监护室肺部感染病原体分布及耐药性剖析 　　摘要：目的：探讨神经内科重症监护室（NICU）住院患者肺部感染的病原菌分布及其对抗菌素的耐药性，指导临床合理用药。方法：收集2012年4月至2013年月95例住院患者例痰标本，细菌的鉴定及药敏试验应用VITEK2系统进行分析。结果：从308个痰标本分离出194例阳性菌株，其中，其中革兰阴性菌 162株，占83.50%，最常见的革兰阴性菌是肺炎克雷伯菌。革兰阳性菌 5 例，占2.58% ，其中最常见的菌株是金黄色葡萄球菌。真菌 27株，占13.92%，且最常收集到的是白色念珠菌。亚胺培南是对革兰阴性菌和革兰阳性菌最有效的抗生素。革兰阳性菌对青霉素的耐药率为100%，而替考拉宁、万古霉素、利奈唑胺对革兰阳性菌100%敏感。结论：NICU患者肺部感染的致病菌以革兰阴性菌为主，其次是真菌感染，应注意合理使用抗生素并加强对细菌耐药性的全面检测。 　　关键词：神经内科重症监护室；肺部感染；耐药性 　　Abstract：Objective： Discussion neurology intensive care unit （NICU） hospitalized patients with pulmonary infection of pathogenic bacteria distribution and drug resistance to antibiotics， to guide clinical rational drug use. Methods： From April 2012 to 2013 years， 95 cases of hospitalized patients with sputum samples， bacterial identification and drug sensitivity test application VITEK2 system analysis. Results： There were 194 positive strains isolated from 308 sputum samples， of which 162 strains of gram negative bacteria， and 83.50% of the most common gram-negative bacteria were Klebsiella pneumoniae.. Gram positive bacteria in 5 cases， accounting for 2.58%， the most common strain is Staphylococcus aureus. Fungi 27 strains， accounting for 13.92%， and the most often collected is Candida albicans. Imipenem is the gram negative bacteria and gram positive bacteria the most effective antibiotics in lan. Leather of gram positive bacteria to penicillin resistance rate was 100%， and teicoplanin， vancomycin， linezolid for gram and gram positive bacteria was 100% sensitive.Conclusion： the pathogenic bacteria of pulmonary infection in patients with NICU is the main pathogen of Gram-negative bacteria，followed by fungal infection，should pay attention to the rational use of antibiotics and strengthen the comprehensive detection of bacterial resistance. 　　Keywords： Nervous Department of internal medicine； pulmonary infection； drug resistance 　　NICU是神经科急、危重患者进行抢救的区域，NICU感染的发生率比普通病房高，因为患者在诊断和救治过程中，接受各种侵入性操作，例如气管插管气管切开、吸痰等都可增加感染的机率。肺部感染是院内感染最主要的形式。它与住院天数和死亡率