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目的研究无创-有创正压通气患者下呼吸道感染的病原体构成及耐药性。方法 41例给予无创-有创呼吸机辅助通气治疗的患者作为研究对象,采用一次性无菌吸痰管自气管内采集患者痰标本,进行细菌鉴定及药敏实验,观察结果。结果 41例患者进行痰培养143次,分离出菌株69株,阳性率48.25%。分离出的菌株以革兰阴性杆菌为主,主要为铜绿假单胞菌、大肠埃希菌、肺炎克雷伯杆菌、鲍曼不动杆菌,均对亚胺培南的敏感性最高,分别为80.00%、72.72%、77.78%、42.86%,对其他常用药物耐药率较高。白色假丝酵母菌感染率较高,耐药率低。结论接受无创-有创呼吸机辅助通气治疗患者发生革兰阴性杆菌感染者比例高,并且耐药率高,在治疗过程中注意避免交叉感染。根据患者存在的危险因素及疾病严重程度分级,动态检测细菌耐药性,合理选择抗生素。
Objective To study the pathogens and drug resistance of lower respiratory tract infection in non-invasive and invasive positive pressure ventilation patients. Methods A total of 41 patients with noninvasive invasive ventilator-assisted ventilation were selected as the research objects. The sputum samples were collected from the trachea by a disposable sterile suction tube for bacterial identification and drug susceptibility testing. The results were observed. Results 41 patients were sputum culture 143 times, isolated 69 strains, the positive rate of 48.25%. The strains isolated were mainly Gram-negative bacilli, mainly Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, were the highest sensitivity to imipenem, respectively 80.00%, 72.72%, 77.78%, 42.86%. The rates of resistance to other commonly used drugs are high. Candida albicans infection rate is high, low resistance rate. Conclusions The proportion of Gram-negative bacilli in patients receiving noninvasive-invasive ventilator-assisted ventilation is high and the drug resistance rate is high. Care should be taken to avoid cross-infection during the course of treatment. According to the patient’s risk factors and the severity of the disease grading, dynamic detection of bacterial resistance, a reasonable choice of antibiotics.