摘要
目的探讨急诊重症监护病房(EICU)呼吸机相关性肺炎(VAP)的临床及病原学特点,提高对VAP的防治水平。方法对54例VAP患者的临床资料分析与VAP发生率的关系,对病原学采用气道分泌物培养及药物敏感试验。结果148例人工气道机械通气患者中54例发生VAP,VAP发生率为36.5%;VAP组上机时间明显长于非VAP组,预防性使用抗菌药物不能降低VAP的发生率;共检出病原菌59株,前5位病原菌分别为铜绿假单胞菌(22.0%)、鲍氏不动杆菌(16.9%)、金黄色葡萄球菌(15.3%)、大肠埃希菌(10.1%)、肺炎克雷伯菌(10.1%)。结论VAP是机械通气治疗失败的重要原因之一,防治VAP应重视消毒、无菌操作以及根据药敏试验合理使用抗菌药物。
OBJECTIVE To explore the clinical and etiological characteristics in patients with ventilator-associated pneumonia （VAP） in emergency intensive care unit（EICU）, and improve the prevention and treatment level of VAP. METHODS To analyze the clinical information of 54 patients with VAP, and to compare the clinical information with the incidence rate of VAP. Bacterial culture of airway secretion and drug sensitive test were used to analyze etiology. RESULTS Totally 148 patients were enrolled in this study, of which 54 were diagnosed as VAP. The incidence rate of VAP group was 36.5%. Respirator Used time of VAP group was obviously longer than that of non VAP one. Antibiotic prophylaxis could not lower the incidence rate. A total of 59 pathogen strains were isolated by bacteria culture. The major pathogenic bacteria in VAP were Pseudomonas aeruginosa （22.0 %）, Acinetobacter baumannii （ 16.9 % ）, Staphylococcus aureus （ 15.3 % ）, Escherichia coli（ 10. 1% ）, and K lebsiella pneumonia （10. 1%）. CONCLUSIONS VAP is one of the significant reasons for failed mechanical ventilation treatment. To prevent and treat VAP should pay attention to disinfection and aseptic manipulation, and make the rational use of antimicrobial agents.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2007年第6期654-656,共3页
Chinese Journal of Nosocomiology
关键词
急诊重症监护病房
呼吸机相关性肺炎
临床研究
Emergency intensive care unit
Ventilator-associated pneumonia
Clinical study
