呼吸机相关肺炎56例临床分析

Clinical analysis of 56 cases of mechanical ventilationassociated pneumonia

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56例VAP患者的临床资料。结果检出致病菌82株,其中革兰阴性细菌(G-菌)占67.07%(55株),革兰阳性细菌(G±菌)占20.73%(17株),真菌占12.20%(10株);前4位致病菌分别为铜绿假单胞菌(28株)、肺炎克雷白氏菌(13株)、白色念球菌(10株)、金黄色葡萄球菌(8株)。药敏结果显示这类菌株耐药现象严重。结论呼吸机相关性肺炎病原菌以G-菌为主,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 antimicrobial resistance in ventilator-- associated pneumonia （VAP）. Methods 56 cases of VAP were analysed retrospectively. Results 82 pathogen strains were isolated by bacterial culture, in which Gram--negative bacteria accounted for 67.07 % （55 strains） ,Gram--positive bacteria 20. 73 %（17 strains）,and fungi 12. 20%（10 strains）. P.a.eruginose （28 strains）. P. Klebsiella （13 strains）, moniliasis （10 strains） and S. aureus （8 strains） were the four common kinds of pathogens. All of them showed drug -- resistance to antibiotics. Conclusion Gram--negative bacteria are the most common pathogens of pneumonia isolated from patients with mechanical ventilation in ICU. Sensitive antibiotics should be selected based on the drug sensitive tests to improve the curative rate for VAP.