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目的了解重症医学科机械通气患者下呼吸感染的发病情况及相关病原学分布及动态变化,为医院院感工作提供依据。方法对江门市中心医院重症医学科2011年至2013年收治的568例接受机械通气的患者进行回顾性调查研究,对发生下呼吸道感染患者留取的下呼吸道分泌物进行病原学分析。定量培养液浓度≥107 CFU/ml的病原体为气道内致病菌。结果 3年期间机械通气患者每年下呼吸道感染发生率为55%,G-菌(66.05%)仍是重症医学科院内感染的主要致病菌,铜绿假单胞菌最为常见,占G-菌30.09%,而鲍曼不动杆菌检出比例逐年升高,2013年已上升成为第一位致病菌;G+菌中金黄色葡萄球菌最多见,占G+菌62.10%;真菌中念球菌(99.09%)最为多见,白假丝酵母菌呈逐年下降趋势,而非白念菌有逐年上升趋势。结论重症医学科机械通气患者是发生院内下呼吸道感染的高危人群,及时进行病原学检测,准确把握病原菌的动态变化,是有效控制院内感染的关键。
Objective To understand the incidence and related etiological distribution and dynamic changes of respiratory infections in patients with mechanical ventilation in critical care department and provide basis for hospital nociception. Methods A retrospective study was conducted on 568 patients undergoing mechanical ventilation admitted to the Department of Critical Care Medicine, Central Hospital of Jiangmen from 2011 to 2013, and the etiology of lower respiratory tract secretions in patients with lower respiratory tract infection was analyzed. The pathogen of quantitative culture fluid concentration ≥ 107 CFU / ml is airway pathogenic bacteria. Results The prevalence of lower respiratory tract infection was 55% in patients with mechanical ventilation during the three years. G-bacteria (66.05%) was still the main pathogen of severe infections in hospital. Pseudomonas aeruginosa was the most common, accounting for 30.09% %, While the detection rate of Acinetobacter baumanni increased year by year, and rose to become the first pathogen in 2013. Staphylococcus aureus was the most common in G + bacteria, accounting for 62.10% of G + bacteria. Candidiasis in fungi (99.09% ) Is the most common, Candida albicans showed a downward trend year by year, while non-albino bacteria increased year by year. Conclusions The patients with mechanical ventilation in the intensive care unit are the high risk groups of nosocomial lower respiratory tract infection. Timely pathogen detection and precise grasping of the dynamic changes of pathogens are the keys to effective nosocomial infection control.