新生儿呼吸机相关性肺炎发病情况、病原及耐药菌分析

Prevalencl,Distribution and Antibiotic Resistance of Neonatal Bacteria of Ventilator Associated Pneumonia(VAP)

目的:探讨新生儿呼吸机相关性肺炎的发病率、病原菌感染现状及耐药性,为防治新生儿呼吸机相关性肺炎提供科学依据。方法:对我院儿科NICU病区60例机械通气患者的临床资料进行回顾性研究,分析呼吸机相关性肺炎的临床资料及呼吸道分泌物细菌培养与药敏结果。结果:本组新生儿呼吸机相关性肺炎的发生率为53·3%,病原菌以革兰阴性杆菌为主,占菌株总数的85·2%;以铜绿假单胞菌、克雷伯杆菌、鲍曼不动杆菌、大肠埃希氏菌为主要致病菌,且多为耐药菌。结论:新生儿呼吸机相关性肺炎发病与机械通气时间呈正相关,与新生儿成熟度负相关,病原菌以革兰阴性杆菌为主,对三代头孢普遍耐药,对哌拉西林、他唑巴坦耐药率仅17·4%,对既往报道不耐药的亚胺培南也有13·1%耐药。

Objective：To investigate the prevaleme,distribution and antibiotic resistance of neonate bacteria of ventilator associated pneumonia （VAP） and providil VAP preventionls Meonctal therapeilial stoatego.Methods：60 cases with mechanical ventilation were analyzed retrospectively of clinical data of VAP and bacteria separation of secretion in respiratory tract and antibiotic susceptibility.Results：The incidence of VAP in neonate was 53.3%.Gram-negative bacilli accouted for 85.2%.P.Aeruginosa,K.pneumoniae,acinetobacter baumanii,and Escherichia coli were the mainly gram-negative bacilli with drug resistance. Conclusions：The incidence of VAP in neonate was associated with the time of mechanical ventilation positively and with the maturation of neonate negatively.Gram-negative bacilli were the mainly bacilli,which resistant to the third generation cephalosporin prevalently.The resistant rate to Piperacillin-Tazobactam was merely 17.4% and it to Imipenem was 13.3%,which once reported disresistant.