60例新生儿呼吸机相关肺炎病原培养和药敏分析

Etiological culture and drug susceptibility analysis on ventilator-associated pneumonia in neonates

目的:分析新生儿呼吸机相关肺炎(VAP)的病原和药敏试验结果。方法:对60例VAP患儿在撤机时无菌操作下留取气管导管末端分泌物进行细菌培养并作药敏试验。结果:60例标本检出50株病原菌,阳性率83.3%,病原菌前5位依次是大肠埃希菌、恶臭假单胞菌、铜绿假单胞菌、肺炎克雷伯菌、表皮葡萄球菌;革兰阴性杆菌40例(80.0%),革兰阳性球菌6例(12.0%),真菌2例(4.0%)。革兰阴性杆菌敏感药物前5位依次是亚胺培南/西司他丁(泰能)、环丙沙星、克林霉素、头孢他啶、头孢哌硐+舒巴坦,表皮萄萄球菌对万古霉素敏感,对其余大部分抗生素均耐药。结论:VAP致病菌主要是耐药性条件致病菌,综合防治至关重要。

Objective： To analyze the spreading and drug susceptibility of bacteria of VAP. Methods： The bacteria specimens left by the 60 VAP in the tracheal catheter were cultured and tests on the drug susceptibility were performed. Results： 50 strains of pathogenic bacteria （83.3 % ） were obtained from the 60 samples. Escherichia coli, pscudomonas putida, pscudomonas aeruginosa, klebsiella pneumoniae and staphylococcus epldermidi occupied the top 5. Gram negative baciUis were sensitive to imipenem/cilastatin, ciprofloxacin, clindamycin, ceftazidime and cefoperazone/sulbactam. Staphylococcus epidermidi was sensitive to vancomycin. Conclusions： VAP was mainly caused by conditioned pathogen and integrate control is very important.