ICU呼吸机相关性肺炎的病原菌分布及耐药特点

Distribution and drug resistance of pathogenic bacterium from patients with Ventilmor- Associated Pneumonia in intensive care unit

目的 探讨重症监护病房（ICU）呼吸机相关性肺炎（VAP）患者病原菌分布及耐药特点.为其临床诊治提供依据.方法 对56例ICU中VAP患者的细菌分布及耐药性进行分析.结果 从VAP患者的下呼吸道深部分泌物标本中分离出122株病原苗,其中G-杆菌81株（66.4%）,普遍耐药严重,前三位是鲍曼不动杆菌26株（21.3%）、铜绿假单胞菌22株（18.0%）、嗜麦芽窄食单胞菌11株（9.0%）,G＋球菌33株（27.0%）,主要是金黄色葡萄球菌22株（18.0%）.对苯唑西林耐药率高达76%,万古霉素仍是治疗金葡菌最敏感药物;真菌8株（6.6%）.结论 G-杆菌是ICU中导致VAP的主要病原菌,且对多种抗菌药物耐药,根据药敏选用适宜抗菌药物尤为关键.

ObjectiveTo investigate the distribution characteristic and drug resistance of pathogenic bacterium from patients with Ventilator - Associated Pneumonia（VAP） in intensive care unit（ICU） and provide the foundation for their clinical diagnosis and treatment. Methods The distribution feature and drug resistance of bacteria from 56 VAP patients in ICU were analyzed. Results Totally 122 pathogenic bacterium strains were isolated from the seeretioruq of the lower respiratory tract of VAP patients, among them 81 strains were Gram - negative bacteria, the percentage of this group was 66.4%, high drug resistanee, and three strains ahead of which were 26 Acinetobacter baumarmii strains. 22 Pseudomonas aeruginosa strains and 11 Stenotrophomonas maltophilia strains; the percentage of these three groups was 21.3 %, 18.0 % and 9. 0%, respectively;27.0% of the total 122 strains was 33 G ＋ eoeeobaeteria strains mainly inehiding 22 Staphylococcus aureus strains and 8 fungi stains, the percentage of these two groups was 18.0 % and 6.6 go, respectively. The detection rate of the oxaeillin - resistance Staphylococcus attreus was 76% and the most sensitive drug to Staphylococcus anreus is still vaneomyein. Conclusion The major pathogenic bacterium leading to VAP in ICU is Gram - negative bacteria, which are resistant to a variety of antibaeterials,so choosing appropriate antibacterialsbser on drug sentivity is particularly important.