摘要
目的探讨近年新生儿层流病房应用后新生儿呼吸机相关性肺炎(VAP)的病原菌变迁及药物敏感性情况。方法系统回顾我院新生儿重症监护病房(NICU)近4年接受机械通气﹥48h的287例患儿的临床资料,以发生时间先后分成两组,分析其VAP发病情况、痰培养病原学、药敏结果及治疗转归等。结果近4年NICU的VAP发生率为15.68%,培养出致病菌株共32株,依次为缓症链球菌、嗜麦芽窄食单胞菌、溶血葡萄球菌、肺炎克雷伯菌等。前两年病原菌以革兰阳性菌为主,主要是缓症链球菌和葡萄球菌属,近两年以革兰阴性杆菌为主,尤以嗜麦芽窄食单胞菌居多。以万古霉素、环丙沙星、氧氟沙星为主要敏感药物,对青霉素类抗生素及第二、三代头孢菌素普遍耐药。结论近年VAP致病菌谱发生显著改变,以耐药性条件致病菌为主,强调综合治疗,预防为主,尽早使用敏感药物。
Objective To study the distribution and drug sensitivity of pathogenic bacteria and the occurrence of ventilator-associated pneumonia （VAP） in newborn nursery. Methods Clinical data of 287 cases of VAP receiving mechanical ventilation for 〉 48 hours in the past 4 years were retrospectively reviewed. The patients were divided into two groups according to the disease occurrence, results of sputum culture, drug sensitivity and treatment outcome. Results In the past four years, the incidence rate of VAP was 15.68%. 32 pathogenic species, including Streptococcus mitis, S. maltophilia, hemolytic Staphylococcus, Klebsiella pneumoniae Jun Deng, were identified. Gram-positive bacteria, mainly Streptococcus mitis and Staphylococcus, were the major isolates obtained in the first two years, while Gram-negative bacteria （S. maltophilia） were the major isolates in the subsequent years. The isolates were sensitive to vancomycin, ciprofloxacin and ofloxacin, but resistant to penicillin antibiotics and the second/third generation cephalosporin. Conclusion The spectrum of antibiotics sensitivity of pathogenic bacteria was significantly changed in the past few years. Comprehensive treatment with suitable antibiotics may prevent the development of drug resistance.
出处
《热带医学杂志》
CAS
2009年第7期787-789,共3页
Journal of Tropical Medicine
关键词
新生儿
呼吸机相关性肺炎
致病菌
药物敏感性
newborn
ventilator-associated pneumonia
pathogenic bacteria
drug sensitivity
