CAJ | 학술논문

目的：研究ICU中建立人工气道患者呼吸道获得性感染的发生率、致病菌、药敏和耐药情况。方法：分析1998年1月至1999年3月间，收住本院ICU中建立人工气道患者的呼吸道分泌物的常规培养和药敏资料。结果：36例43次呼吸道分泌物培养阳性35次，阳性率81．4％。其中细菌30株，占85．7％，共14个菌种；霉菌5株，占14．3％，共2个菌种，均为真菌。细菌和真菌混合感染5例，达14．3％。革蓝氏阴性杆菌（G）主要为铜绿假单胞菌（28．6％）、鲍曼氏不动杆菌（11．4％）、阴沟杆菌（8．6％）。革蓝氏阳性球菌（G）主要为表皮葡萄球菌（11．4％）、溶血性葡萄球菌（2．9％）。药敏结果为：对青霉素类、氟喹诺酮类、氨基苷类、头孢三代耐药G杆菌分别达75％、42．1％、40．4％、26．1％，G球菌分别达50％、36．2％、22．5％、15．7％。结论：ICU中建立人工气道患者的呼吸道获得性感染的控制是危重病抢救过程中一个及其重要的环节。由于广谱抗生素的广泛应用，耐药菌株和二重感染日益增多，应用适当抗生素预防和治疗，已成为一个不可忽视的课题。
목적：연구ICU중건립인공기도환자호흡도획득성감염적발생솔、치병균、약민화내약정황。방법：분석1998년1월지1999년3월간，수주본원ICU중건립인공기도환자적호흡도분비물적상규배양화약민자료。결과：36례43차호흡도분비물배양양성35차，양성솔81．4％。기중세균30주，점85．7％，공14개균충；매균5주，점14．3％，공2개균충，균위진균。세균화진균혼합감염5례，체14．3％。혁람씨음성간균（G）주요위동록가단포균（28．6％）、포만씨불동간균（11．4％）、음구간균（8．6％）。혁람씨양성구균（G）주요위표피포도구균（11．4％）、용혈성포도구균（2．9％）。약민결과위：대청매소류、불규낙동류、안기감류、두포삼대내약G간균분별체75％、42．1％、40．4％、26．1％，G구균분별체50％、36．2％、22．5％、15．7％。결론：ICU중건립인공기도환자적호흡도획득성감염적공제시위중병창구과정중일개급기중요적배절。유우엄보항생소적엄범응용，내약균주화이중감염일익증다，응용괄당항생소예방화치료，이성위일개불가홀시적과제。
Objective：In order to investigate the incidence of hospital acquired respiratory tract infection in the patients with artifical airway in ICU and study the species of pathogenic organism and bacterial drug resistant spectrum and bacterial drug resistant spectrum．Methods: The results drug susceptibility tests in patients with artifical airway from Jan，1998 to Mar．1999 were analyzed，retrospectively．Results: of 43 cultures in 36 patients，the positive rate is 81．4％，30 strains of bacteria 85．7％ and 5 strains of fungus（14．3％）were found in cultures．There were 14 species of bacteria and 2 species of fungs in infection patients．5 cases of patients（14．3％）had mixed infection．The predominant species of Gram（-）bacilli were PS．aeruginos（28．6％）．Acinetobacter baumanii（11．4％）and Enterobacter cloacae （8．6％）．The species of Gram（＋）cocci were S．epideridis（11．4％）and Staphylococcus hemolysis（2．9％）．The resistance rate of Gram（-）bacilli to Penicillin，Quinolone，Amikacini and the third generation Cephalosporins were 75％，42．1％，44．4％and 26．1％，respectively．Conclusion Hospital acquired respirator tract infection control plays a key role in the treatment of critically ill patients with artifical airway．Multi-drug-resist and bacteria and mixed infection are very common．We must pay more attention to the monitory of acquired infection and using antibiotics reasonable．