摘 要目的：了解基层医院重症监护病房(ICU)中呼吸机相关性肺炎(VAP)病原菌的分布及耐药性特点，为临床用药提供参考资料。方法：对2003年6月——2008年5月确诊VAP患者分离到的病原菌进行鉴定，并采用纸片扩散法进行药物敏感试验。结果：VAP病原菌中革兰氏阴性菌为主，占68.85%，革兰氏阳性菌其次占24.6%、真菌占6.55%；位于前5位的病原菌依次为铜绿假单胞菌、金黄色葡萄球菌、鲍氏小动杆菌、大肠埃希菌、嗜麦芽寡养单胞菌；亚胺培南、美罗培南对主要的革三阴性菌有效；MRSA成为VAP病原菌的第二位，对万古霉素100.0%敏感。 结论：革兰阴性杆菌仍是基层医院ICU导致VAP的主要病原菌，且对多种抗菌药物耐药，MRSA成为VAP第二位的病原菌。

    关键词重症监护病房；呼吸机相关性肺炎；病原菌；耐药性

    AbstractOBJECTIVE：To investigate the distribution and drug resistance of pathogenic bacteria in our ICU of Basic-Level-Hospitall .METHODS：Animicrobial susceptibility of pathogenic bacteria isolated from ventilator asslciated pneumonia (VAP) patbogeng of VAP were Gram-negative bacilli(68.85%),the second were Gram-positive organisma(24.6%),the third were fungi(6.55%).The most common pathogens were Staphylococcus aureus, Acinetobacter baumanntt ,Escherichia coli,and Stenotrophomunas maltophilia.Imipenem and meropenem had the better antimicrobial susceptibility to Gram-negative bacilli. Piperacillin/tazobactam had the better antimicrobial susceptibility to Pseudomonas aeruginosa.The main pathogenic Gram-positive organism was meticillin-resistant L. aureus (MRSA).All strains of MRSA were antimicrobial sensitive to vancomycin, CONCLUSIONS：Grani negative bacilli are the next pathogen of VAP. ......