我院新生儿呼吸机相关性肺炎病因学研究及用药分析

Etiological Survey and Evaluation of Drug Use of Ventilator Associated Pneumonia in Newborn

目的:了解新生儿呼吸机相关性肺炎(VAP)的危险因素、病原菌及用药情况。方法:采用相关因素分析法分析新生儿VAP的危险因素,以VAP发生率为指标评价抗生素疗效。结果:分娩方式及机械通气时间可能为VAP的危险因素。肺炎克雷伯菌和鲍曼不动杆菌为新生儿VAP主要病原菌。抗生素疗效评价显示,联合用药预防VAP的有效性为66.67%～85.71%,而单药预防仅为57.14%。结论:依据病原菌分布和药敏试验结果,推荐将广谱抗生素作为本地区新生儿VAP经验性用药。抗生素联合用药预防VAP优于单药预防,但此结果仍有待进一步研究证实。

OBJECTIVE： To analyze the risk factors, etiology and medication of ventilator associated pneumonia（VAP） in newborn. METHODS： Related factor methods were adopted to analyze the risk factors of newborn VAP and the clinical efficacy of anti- biotics was evaluated using the incidence of VAP as index. RESULTS： Delivery way and duration of intubation were relative to VAP. Klebsiella pneumoniae and Acinetobacter baumannii were two main pathogenic bacteria. Clinical efficacy evaluation of antibiotics showed that effectiveness of polytherapy was 66.67% -85.71% while that of monotherapy was 57.14%. CONCLUSIONS： According to the drug sensitivity analysis and distribution of pathogenic bacteria, broad-spectrum antibiotics can be recommended as the empirical therapy for VAP. Our study suggests that polytherapy might be better than monotherapy in terms of preventing VAP, but this conclusion still needs to be confirmed in future studies.