呼吸机相关性肺炎病原菌及耐药性调查

Analysis of the Distribution and Drug Resistance of Pathogens in Ventilator-associated Pneumonia

目的探讨呼吸机相关性肺炎(VAP)的病原菌及其耐药性,为防治VAP提供科学依据。方法对VAP的病原菌及耐药性进行调查,分析125例VAP患者的发病年龄、基础疾病、病原菌分布及革兰阴性杆菌耐药率等。结果VAP发生率29.9%,老患者占30.4%。VAP病原菌以G-杆菌为主,占菌株总数的72.1%,其中鲍曼不动杆菌居首位;铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、嗜麦芽寡单胞菌及金黄色葡萄球菌是VAP的主要致病菌。产超广谱β-内酰胺酶细菌分离率为33.1%,G-杆菌对常用抗药物已表现出较高的耐药率。结论对机械通气进行全面预防,提倡严密动态监测VAP病原菌,合理使用抗生素,以达到有效控制VAP的目的。

Objective To investigate the distribution and drug resistance of pathogens in ventilator-associated pneumonia （VAP） in order to provide evidence for prevention and therapy of VAP. Methods The clinical characteristics of 125 VAP cases, including onset age, basic diseases, distribution of pathogens and drug resistance of gram-negative bacilli, were reviewed, Results The incidence of VAP was 29. 9%, of which the aged accounted for 30.4%. Among all pathogens caused VAP, Gram-negative bacilli accounted for 72.1%, in which Acinetobacer baumanii contributed majority, and ESBLs accounted for 33.1%. Conclusions The high resistance rate to common used antibiotics in Gram-negative bacilli had emerged. To effectively control VAP, exensive and dynamical monitoring of VAP pathogens and rational use of antibiotics are advocated.