ICU内呼吸机相关性肺炎的病原茵分布及耐药性分析(1)
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【摘要】 目的 探讨ICU内呼吸机相关性肺炎(VAP) 的病原菌分布及其耐药性,为临床防治提供依据。方法 对我院ICU科60例呼吸机相关性肺炎患者的病原菌构成及耐药率进行分析。结果 共检出病原菌73株,其中革兰阴性(G-)杆菌占72.6%;革兰阳性(G+)球菌占23.3%;真菌占4.1%。铜绿假单胞菌分离率最高为30.1%,其次为不动杆菌和金黄色葡萄球菌(分别为27.4%和11.0%)。G-杆菌对氨苄西林耐药率最高(90%以上),对碳青霉烯类耐药率最低(15%以下);G+球菌对青霉素类及红霉素耐药率高(60%以上),未发现耐万古霉素的葡萄球菌。结论 ICU呼吸机相关性肺炎病原菌以G-杆菌为主,并且G-杆菌的耐药呈多重耐药性,临床应重视病原菌的检查,有针对性使用抗生素。
【关键词】 重症监护病房;呼吸机相关性肺炎:病原菌:耐药性
The research of pathogenic bacteria distribution in ICU their drug tolerance in Ventilator-Associated pneumonia
CHEN Xian-liu.The People’s Hospital of Anhua County, Hunan Province. Anhua413500, China
【Abstract】 Objective To investigate the pathogen spectrum distribution and antimicrobial resistance in ventilator-associated pneumonia in intensive care unit(ICU)and provide evidence for clinical prevention and treatment.Methods Among 60 patients with ventilator-associated pneumonia in ICU in our hospita1.pathogens distribution and resistance rate were analyzed.Results Among 73 strains of isolated pathogens,the gram-negative bacteria accounted for 72.6%,the gram-positive bacteria for 23.3%,and the fungi for 4.1%.The isolating rate of Pseudomonas aeruginosa was the most highest 30.1% and then was the Acinetobacter and Staphylococcus aurous (each for 27.4% and 11.0%).Gram-negative bacillus showed in a high resistance to piperacillin (above 90%),but high susceptibility to carbapenems(lower than 15%).Gram-positive coccobateria showed a high resisptibility to penicillin and Erythromycin(above 60%),but not found the strains can resisted the Vancomycin.Conclusion Gram-negative bacteria was the majority of the pathogens isolated from patients with ventilator-associated pneu.monia in ICU.Clinical doctors should think highly of pathogen detection and rational application of antibiotics.
【Key words】 Intensive care unit;Ventilator-associated pneumonia;Pathogen;Antibiotic resistance
作者单位:413500湖南省安化县人民医院检验科
呼吸机相关性肺炎(Ventilatior-associated pneumonia VAP)是机械通气过程中常见的并发症之一,其发生率为9%～7O%[1]。一旦出现VAP则容易造成撤机困难,延长患者住院时间,严重者还会威胁患者生命,导致机械通气失败。本文对ICU内VAP患者病原菌及药敏检测结果进行回顾性分析,为临床治疗提供实验依据,现将结果报告如下。
1 资料与方法
1.1 一般资料 2006年1月至2010年4月ICU收治的使用呼吸机48 h以上的患者142例,所有患者符合中华医学会呼吸病学分会所制定的诊断标准[2] ......
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