急诊ICU呼吸衰竭并肺部感染患者的病原学及耐药性分析

毛小强　　陈毓　　姜锋芒

[關键词] 耐药性;病原学;肺部感染;呼吸衰竭

[中图分类号] R378          [文献标识码] A          [文章编号] 1673-9701（2021）21-0018-04

Analysis on the etiology and drug resistance of patients with respiratory failure complicated with pulmonary infection in emergency intensive care unit

MAO Xiaoqiang   CHEN Yu   JIANG Fengmang

Department of Emergency， the People′s Hospital of Quzhou City in Zhejiang Province， Quzhou   324000， China

[Abstract] Objective To investigate the types of pathogens and drug resistance of pathogenic bacteria in patients with respiratory failure complicated with pulmonary infection in emergency intensive care unit （EICU）. Methods A total of 187 patients with respiratory failure complicated with pulmonary infection admitted to EICU of our hospital from January 2015 to December 2019 were selected. Sputum samples were collected from all patients for bacterial culture and drug sensitivity test was carried out to observe the types of pathogens and drug resistance of pathogenic bacteria in patients with respiratory failure complicated with pulmonary infection. Results A total of 220 strains of pathogenic bacteria were obtained from 187 patients after bacterial culture and isolation， of which 50 strains were Gram-positive cocci （22.73%） and 170 strains were Gram-negative bacilli （77.27%）. The highest proportion of Gram-positive cocci was staphylococcus haemolyticus （8.64%）， coagulase-negative staphylococcus （5.45%） and Staphylococcus aureus （4.55%）. Among Gram-negative bacilli， the highest proportion of Gram-negative bacilli was pseudomonas aeruginosa （23.64%）， Klebsiella pneumoniae （20.45%） and acinetobacter Baumannii （18.64%）. Among clinical respiratory failure with pulmonary infection， the drug resistances of pseudomonas aeruginosa， Klebsiella pneumoniae and acinetobacter Baumannii were higher， and Klebsiella pneumoniae was the most significant in drug resistance. Among Gram positive bacteria， Staphylococcus haemolyticus， coagulase negative Staphylococcus and Staphylococcus aureus had the highest drug resistance， among which Staphylococcus aureus was the most significant. Conclusion Gram-negative bacilli are the main pathogenic bacteria in patients with respiratory failure complicated with pulmonary infection in the EICU， and they all have certain drug resistance to commonly used clinical antibiotics， among which Klebsiella pneumoniae has the highest drug resistance. Therefore， it is necessary to master the types of pathogenic bacteria and the results of drug sensitivity test， and to choose antibiotics reasonably to improve the treatment efficacy when treating patients with respiratory failure complicated with pulmonary infection in EICU.