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Constituent ratio and change of bacterial strains in critically ill patients with severe pulmonary infection before and after mechanical ventilation
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- Author:
- No author available
- Journal Title:
- CHINESE CRITICAL CARE MEDICINE
- Issue:
- 8
- DOI:
- 10.3760/j.issn:1003-0603.2002.08.005
- Key Word:
- 肺感染;机械通气;抗生素
Abstract： 目的:探讨机械通气前后不同类型严重肺感染和抗生素应用时相应各时段的致病细菌构成与转换,为临床治疗提供有效依据.方法:收集本院近年来危重症行机械通气患者共629例,按肺感染的不同类型和时段,在使用抗生素时观察其痰中培养出致病菌的种类和构成比.结果:院前肺感染组(172例)革兰阳性(G+)菌的构成比较混合肺感染组和院内肺感染组均高(分别为76.0%,37.8%,11.9%),P均<0.01;而G-菌则表现为院内肺感染组及混合肺感染组较院前肺感染组高且差异显著(分别为88.1%,62.0%,24.0%),P均<0.01.3组中G+菌以肺炎球菌、金黄色葡萄球菌和肠球菌为主;而G-菌则以绿脓杆菌、不动杆菌和克雷白杆菌为主,同时伴有霉菌生长.在对112例严重肺感染患者进行继续观察时发现,在不同时段中可见到从G+菌到G-菌的动态转变.结论:不同类型的肺感染其致病菌有显著差异,同种肺感染的不同治疗阶段细菌构成比也在转变.选择抗生素时既要对其致病菌有针对性,又要对细菌随时间而改变有预测性.
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