新生儿呼吸机相关性肺炎病原菌分析及防治探讨

Correlativity pneumonia pathogenic bacteria analyses newborn baby breath machine reaching prevention and cure investigation and discussion

目的分析新生儿呼吸机相关性肺炎(VAP)病原菌特点、耐药性及药敏试验,探讨合理的防治措施。方法收集2007年月1月至2008年4月中应用呼吸机治疗的68例患儿临床资料,对机械通气超过48h者,取支气气管分泌物进行培养、菌种鉴定及药敏试验。结果①发生VAP40例,发生率58.8%;②分离出病原菌52株,全部为G-杆菌,产ESBLs菌22株;发生菌群交替(不同时间培养出不同致病菌)20株,病原菌耐药率高;③发生VAP者治愈率70.0%,未发生VAP者治愈率82.0%,χ2=9.052,P<0.05,两者相比有统计学意义。结论VAP致病菌普遍耐药,尤其是产ESBLs菌;病原菌复杂易变,发生菌群交替;VAP影响新生儿疾病治愈率,治疗VAP关键在于选择有效抗生素,加强预防是控制VAP的重要措施。

Objective ： Analysis of neonatal ventilator - associated pneumonia （VAP） pathogen characteristics, resistance and sensitivity test on reasonable control measures. Methods ： 2007 Date January to mid - 2008 with four ventilator - treatment of 68 cases of children with clinical data on mechanical ventilation 〉 48 h, with gas from tracheal secretions were cultured species identification and sensitivity test. Results： ①Occurred VAP40 cases, the incidence was 58. 8% ; ②Pathogens isolated from the 52, all of the G - bacteria, ESBLs -producing strains 22; flora in the turn （at different times to different pathogens training） 20, the high rate of resistant pathogens ;③ A cure rate of 70. 0 percent to VAP, not a cure rate of VAP to 82. 0% ,χ^2 = 9. 052, P 〈 0. 05, compared with the two statistically significant. Conclusion： VAP generally resistant pathogens, especially ESBLs - producing bacteria; pathogens complex volatile, in turn flora ; VAP affect the cure rate of neonatal disease, treatment of VAP key lies in choosing effective antibiotics to prevent VAP is an important control measures.