摘要
目的了解重症监护病房内呼吸机相关肺炎(VAP)的病原体分布特征及其耐药性情况。方法回顾性分析2004年9月—2007年3月重症监护病房内确诊VAP的63例患者的临床资料,病原体构成及耐药性。结果共培养出病原体116株,其中革兰阴性杆菌83株,革兰阳性球菌26株,真菌7株。常见病原体为肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌、铜绿假单胞菌。药敏试验显示VAP常见病原体对哌拉西林/三唑巴坦、头孢哌酮/舒巴坦有较好的敏感性,而对亚胺培南的耐药性提高。结论 VAP感染的主要病原体为革兰阴性菌且呈现多重耐药现象,治疗时应特别注意对下呼吸道病原体的检测,根据细菌培养和药敏试验结果合理使用抗菌药物。
Objective To understand the distribution of pathogens of ventilation - associated pneumonia （VAP） in in- tensive care unit （ICU） and the condition of their drug resistance to antibiotics. Methods A retrospective clinical study on 63 patients with VAP was carried out from September 2004 to march 2007. The pathogens and their drug resistance were analyzed. Results A total of 109 pathogen strains were identified by bacterial euhure, of which Gram positive cocci were 26 strains, Gram - negative cocci were 83 strains, and fungi were 7 strains. The most common isolated bacteria of the pathogen spectrum in VAP were klebsiella pneumoniae, esoheriohia eoli, acinetobacter and pseudomonas aeruginosa. Drug sensitivity tests indicated that the bacteria had lower drug - resistance to piperacillin plus sulbactam, cefoperazone plus sulbacactam, but the drug resistance to imipenem increased. Conclusion The major pathogens in VAP were Gram - negative cocci and there were often multiple drug resistant tests. Particular attention should be paid to detection of the bacteria from lower respiratory treat, and the antibiotics should be selected according to the results of bacterial culture and drug sensitivity test.
出处
《临床合理用药杂志》
2011年第06X期55-57,共3页
Chinese Journal of Clinical Rational Drug Use
关键词
呼吸机相关肺炎
病原体
耐药性
重症监护病房
Ventilation- associated pneumonia
Pathogen spectrum
Drug resistance
Intensive care unit
