Наталія Дмитрівна Герасименко, Наталія Іванівна Дігтяр
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引用次数: 0

摘要

呼吸道感染性病变,特别是医院感染性肺炎的发病率和死亡率问题,仍然是现代医学最紧迫的问题之一。医院性肺炎在医疗机构感染的所有传染病中排名第三,仅次于泌尿系统和伤口炎症,其特点是死亡率高。医院性肺炎是由抗生素耐药性微生物引起的;在重症监护患者中,由于再次吸入积聚在插管袖带上方的细菌,情况变得复杂。医院和社区获得性肺炎的识别涉及特定的病原体菌群,因此需要经验性治疗。根据革兰氏阴性菌对痰液进行常规分析,得出了大致的数据,这是对经验性治疗的澄清。我们提出了一个临床病例,该病例表明,由于在医疗机构工作的家庭成员与另一个家庭成员的接触,也可能感染。因此,在我们的临床案例中,我们强调收集完整的病史是非常重要的。仔细收集病史可以提供更多信息:团队工作、医学专业人员、在医疗机构工作的亲属。需要注意的是,在这类患者中,包括医院内肺炎在内的感染病原体可能是医院内微生物菌株。无论年龄大小,我们都建议使用预防措施(改变生活方式、适应训练、运动等)来增加身体的非特异性抵抗力。作为预防措施,医务人员应遵守场所的通风和湿清洁制度,尽可能经常用盐水洗手和冲洗鼻腔,使用口罩保护呼吸器官,用酒精消毒双手。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
КЛІНІЧНИЙ ВИПАДОК ГОСПІТАЛЬНОЇ ПНЕВМОНІЇ, ВИКЛИКАНОЇ KLEBSIELLA PNEUMONIA, ВНАСЛІДОК КОНТАКТУ ІЗ ЧЛЕНОМ РОДИНИ
The problem of morbidity and mortality due to infectious lesions of the respiratory tract, in particular nosocomial pneumonia, remain one of the most pressing problems of modern medicine. Nosocomial pneumonia ranks 3rd among all infectious diseases that a patient can contract at a medical institution after urinary and wound inflammation and it is characterized by high mortality. Nosocomial pneumonia is provoked by antibiotic-resistant microorganisms; in the intensive care patients, it is complicated by the re-aspiration of bacteria that accumulate above the cuff of the intubation tube. Identification of nosocomial and community-acquired pneumonia involves a particular flora of pathogens and, accordingly, involves empiric therapy. Routine analysis of sputum according to Gram gives approximate data, which is a clarification for empiric treatment. We present a clinical case, which demonstrates that infection is also possible due to contact of a family member with another one, working at a medical institution. Therefore, in our clinical case, we emphasize that it is very important to collect a thorough history. Careful collection of medical history can provide additional information: working in a team, being a medical professional, relatives working at a medical institution. It should be noted that in this category of patients, the causative agent of infection, including nosocomial pneumonia, may be the strains of nosocomial microorganisms. Regardless of age, we recommend the use of preventive measures (lifestyle modification, acclimatization training, sports, etc.) to increase the non-specific resistance of the body. As a preventive measure, medical personnel should follow the regimes of ventilation and wet cleaning in the premises, wash their hands and rinse their nasal passages as often as possible with saline solutions, use a mask to protect the respiratory organs, disinfect hands with alcohol.
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