呼吸机相关肺炎的病原学及耐药性分析

Retrospective clinical analysis on pathogen spectrum distribution and antimicrobid resistance in VAP

目的 探讨呼吸机相关肺炎(VAP)病原学分布特点。方法 回顾分析62例VAP患 者的临床资料。结果 62例VAP患者共分离病原菌81株,革兰氏阴性杆菌占62.9%,革兰氏阳 性菌占19.8%,真菌占17.3%。病原菌以铜绿假单胞菌、大肠埃希氏菌、肺炎克雷伯杆菌、金黄色 葡萄球菌和白色念珠菌为主。分离的细菌除对泰能较敏感外,对其它抗生素均有不同程度耐药。 结论 VAP常为多种病原菌的混合性感染,普遍存在耐药性;选择敏感抗生素可提高VAP治愈率。

Objective To investigate the pathogen spectrum distribution and antimicrobid resistance in ventilation-associated pneumonia(VAP).Methods 62 cases from VAP was analysed retrospectively.Results Eighty-one strains were isolated from specimens.It showed that the isolating rate of Gram negative bacilli,Gram positive cocci and fungus was 62.9%,19.8% and 17.3%,respectively.The most common isolated bacteria of the pathogen spectrum in VAP were Pseudomonas aeruginosa,Escherichia coli and Klebsiella pneumoniae,and Staphylococcus aureus;the most common fungus was Candida albicans.Except that all the strains were sensitive to ipenem,all the other isolated strains showed resistance to all the agents tested in different levels,also the multidrug resistance emerged.Conclusions Sensitive antibiotics should selected based on the drug sensitive tests,combined with other agents which help to improve the curative rate during hospitalisation treatment for VAP.