| 引用本文： |
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韩志青,袁海波,徐晓雯,等.上腹部术后肺部感染病原菌分布特点及耐药性分析[J].同济大学学报（医学版）,2015,36(2):59-64. [点击复制]
- HAN Zhi-qing,YUAN Hai-bo,XU Xiao-wen,et al.Distribution and drug resistance of pathogenic bacteria in abdominal surgery patients with pulmonary infection[J].同济大学学报（医学版）,2015,36(2):59-64. [点击复制]
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| 摘要: |
| 目的 分析上腹部术后患者合并肺部感染病原菌分布及耐药特点。方法 从外科系统入选上腹部手术后并发肺部感染及肺不张患者114例,该114例患者均不能自行咳痰,需通过纤维支气管镜吸痰及支气管肺泡灌洗来清除痰液。并将吸出的痰液或支气管肺泡灌洗液(BALF)标本送细菌培养及药敏试验。结果 灌洗液共分离出病原菌91株,检出率为79.8%。其中革兰阴性(G-)杆菌82株,以铜绿假单胞菌、鲍曼氏不动杆菌、肺炎克雷伯菌和奇异变形杆菌为主；革兰阳性(G＋)球菌6株,以金黄色葡萄球菌为主。药敏结果显示,铜绿假单胞菌对多种抗菌药物耐药性增加,不动杆菌、肠杆菌科细菌对碳青霉烯类抗菌药物耐药率正在逐渐上升,G＋球菌中金黄色葡萄球菌对利奈唑胺、万古霉素耐药率为0。结论 上腹部术后合并肺部感染患者,支气管肺泡灌洗液中检出率高,且感染菌株呈多药耐药,经验性合理选择抗菌药物时应针对上述特点,并减少诱导耐药菌株的产生,以期获得更好疗效。 |
| 关键词: 上腹部手术后肺部感染 病原菌分布 耐药性 |
| DOI：10.16118/j.1008-0392.2015.02.014 |
| 投稿时间：2014-06-12 |
| 基金项目: |
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| Distribution and drug resistance of pathogenic bacteria in abdominal surgery patients with pulmonary infection |
| HAN Zhi-qing,YUAN Hai-bo,XU Xiao-wen,LUO Yan-rong,HUANG Bei-jie |
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| Abstract: |
| Objective To analyze the distribution and antibiotic resistance of pathogenic bacteria in abdominal surgery patients with pulmonary infection. Methods One hundred and fourteen patients with pulmonary infection and pulmonary atelectasis after abdominal surgery were enrolled in the study. Sputum and bronchoalveolar lavage fluid (BALF) specimens were collected for bacterial culture and antibiotic sensitivity test. Results Ninety one bacterial strains were isolated from BALF specimens with a detection rate of 79.8%. Gram-negative (G-) bacilli were 82 strains including, Pseudomonas aeruginosa, Acinetobacter baumanii, Klebsiella pneumoniae and Proteus mirabilis; Gram-positive (G+)cocci were 6 strains, including Staphylococci aureus. Susceptibility results showed an increased drug resistance of P. aeruginosa resistant to multiple antibiotics, of Acinetobacter, Enterobacteriaceae to vinyl carbapenem antibiotics; while none of G+ cocci Staphylococcus aureus strains were resistant to linezolid and vancomycin. Conclusion The detective rate of pathogenic bacteria from BALF specimens is high in patients with pulmonary infection after abdominal surgery, and most of bacterial strains are multi-drug resistant, indicating that empiric antimicrobial agents are necessary for these patients. |
| Key words: lung infection after abdominal surgery pathogen distribution drug resistance |
