2014—2016 年某院无创呼吸机辅助通气后下呼吸道病原菌分布及耐药性

齐志娟

（吴起县医院检验科，陕西 延安，717600）

浏览次数：91次 下载次数：448次

摘要：

目的 探讨无创呼吸机辅助通气后下呼吸道病原菌分布及耐药性。方法 收集我院2014—2016年无创呼吸机辅助通气后患者下呼吸道标本288例，对标本进行细菌培养，观察患者下呼吸道感染的病原菌分布，分析革兰阴性杆菌和金黄色葡萄球菌的耐药性。结果 288份痰液中，共检出病原菌250株，革兰阴性菌占72.00%（180/250），革兰阳性菌占18.00%（45/250），真菌占10.00%（25/250）。鲍曼不动杆菌对哌拉西林、亚胺培南、头孢吡肟、头孢他啶、环丙沙星等药物耐药性均大于55.00%； 铜绿假单胞菌对所有参与抗菌实验药物的耐药率均低于30.00%；鲍曼不动杆菌和铜绿假单胞菌对阿米卡星的耐药率均最低；金黄色葡萄球菌对青霉素G的耐药率均大于90.00%，对庆大霉素和环丙沙星的耐药率较低。结论 无创呼吸机辅助通气患者下呼吸道感染主要以革兰阴性杆菌为主，其耐药性较高。

关键词：无创呼吸机；下呼吸道感染；耐药性

中图分类号：R446.5文献标志码：A文章编号：2096-1413(2017)24-0043-02

Distribution and drug resistance of lower respiratory tract pathogens after assisted ventilation of noninvasive

ventilator in a hospital during 2014-2016
QI Zhi-juan
(Department of Laboratory Medicine, Wuqi County Hospital, Yan``an 717600, China)

ABSTRACT: Objective To discuss the distribution and drug resistance of lower respiratory tract pathogens after assisted ventilation of noninvasive ventilator. Methods A total of 288 cases of lower respiratory tract specimens were collected from patients after assisted ventilation of noninvasive ventilator during 2014-2016. Bacterias were cultured, then the distribution of the lower respiratory tract pathogens was observed, and the resistance of Gram-negative bacilli and Staphylococcus aureus were analyzed. Results Of the 288 sputums, 250 strains were found, 72.00% (180/250) were Gram-negative bacteria, 18.00% (45/250) were Gram -positive and 10.00% (25/250) were fungus. The drug resistance of acinetobacter baumannii on piperacillin, imipenem, cefepime, ceftazidime, ciprofloxacin and other drugs were higher than 55.00%; the drug resistance of pseudomonas aeruginosa to antimicrobial test drugs were lower than 30.00%; the resistance of acinetobacter baumannii and pseudomonas aeruginosa to amikacin were the lowest; the drug resistance of staphylococcus aureus on penicillin G were higher than 90.00%, on gentamicin and ciprofloxacin was low. Conclusion Patients with lower respiratory tract infection after noninvasive assisted ventilator is mainly the Gram-negative bacilli, and it has high resistance.
KEYWORDS: non-invasive ventilator; lower respiratory infection; drug resistance

参考文献：
[1] 任建平,王天轶,王乐,等.无创呼吸机治疗慢阻肺对多项指标的影响[J].临床肺科杂志,2016,21(7):1236-1238.
[2] 陈英华,张立军.BiPAP 无创呼吸机联合呼吸兴奋剂治疗COPD合并域型呼衰的疗效观察[J].临床肺科杂志,2015,26(2):297-299.
[3] 徐晓飞.无创呼吸机治疗急性心力衰竭的疗效观察[J].中华全科医学,2016,14(10):1669-1670.
[4] 石晓强,高素芹.无创呼吸机联合参附注射液治疗急性左心衰竭疗效观察[J].现代中西医结合杂志,2016,25(24):2660-2662.
[5] 喻杨林,张力燕,业秀林,等.影响OSAS 患者应用无创呼吸机依从性因素的分析及对策[J].临床肺科杂志,2015,20(10):1883-1886.
[6] 罗惠玲,黄祥云,赵静山.无创呼吸机联合药物治疗对重症哮喘患者疗效及肺功能的影响[J].实用临床医药杂志,2016,20(17):38-40.
[7] 朱德妹,汪复,胡复品,等.2010 年中国CHINET 细菌耐药性监测[J].中国感染与化疗杂志,2011,11(5):321-329.
[8] 陈宏斌,赵春江,王辉,等.2011 年中国13 家教学医院院内感染常见病原菌耐药性分析[J].中华内科杂志,2013,52(3):203-212.