呼吸机相关性肺炎病原菌研究

The Research of Life-support Machine Pertinency Pnenmococcus

目的:总结分析呼吸机相关性肺炎(VAP)病原菌特点、危险因素布及耐药性,便于控制VAP。方法:对2007年7月～2009年6月确诊的VAP患者分离到的病原菌进行鉴定并用纸片扩散法进行药物敏感试验。结果:187例机械通气的患者发生呼吸机相关性肺炎有83例,VAP发生率为44.38%;共分离出165株病原菌。其中,革兰阴性菌为主,占71.51%;革兰阳性菌为其次,占20.6%;真菌占7.88%。位于前五位的病原菌依次位鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、嗜麦芽假单胞菌、表皮葡萄球菌;亚胺培南对主要革兰阴性菌有较好的敏感性。结论:革兰阴性菌是VAP的主要病原菌,且存在严重的耐药现象。临床医师应根据药敏试验结果合理使用抗生索,及时治疗VAP。

Objective：To analyze characteristics,risk factors and drug resistance of the vemilator-associated pneumonia （VAP） pathogenic bacterias, in order to control VAP easily.Methods：Pathogenic bacterias isolated from diagnosed VAP patients between July 2007 and June 2009 were identified by using the method of disk diffusion for drug susceptibility testing.Results：83 patients of the 187 cases with mechanical ventilation were ventilator-associated pneumonia.And the rate was 44.38%.165 strains of bacteria were isolated.71.51% of them were Gram- negative bacteria,while 20.6% were Gram-positive bacteria.and 7.88% were fungi.In the top five pathogens were Acinetobacter baumannii bit,Pseudomonas aeruginosa, Klebsiella pneumoniae,pseudomonas maltophilia,Staphylococcus epidermidis.Most gram-negative bacterias have great sensitivity to imipenem.Conclusion：Gram-negative bacteria is the main pathogen of VAP, and is seriously resistant to drugs. Clinicians should use antibiotics rationally by the results of susceptibility test and timely treat VAP.