小儿呼吸机相关性肺炎病原菌分布及耐药性分析

Distribution and drug resistance of pathogenic bacterium in children with ventilator associated pneumonia

目的分析小儿呼吸机相关性肺炎(VAP)的病原菌分布及药物敏感性。方法对38例VAP患儿的118份标本进行病原菌类型及药物敏感性分析。结果 118例下呼吸道标本分离出病原菌78株,其中革兰阴性菌44株,革兰阳性菌32株,真菌2株。万古霉素的敏感性最高,其次为替卡西林钠-棒酸钾、亚胺培南西司他丁钠和左氧氟沙星,头孢呋辛、阿奇霉素和哌拉西林敏感性最低。结论 VAP病原菌以革兰阴性菌和金黄色葡萄球菌为主,且耐药率较高,根据药敏试验结果选择合适的抗生素是治疗VAP的关键。

Objective To analyze the distribution and drug sensitivity of pathogenic bacterium in children with ventila- tor associated pneumonia （VAP）. Methods The distribution and drug sensitivity of pathogenic bacterium of one hundred and eighteen samples from thirty-eight children with VAP was analyzed. Results Seventy-eight pathogenic bacterium were isolated from one hundred and eighteen lower respiratory tract samples, among these, forty-four eases were Gram-negative bacteria,thir- ty-two cases were Gram-positive bacteria,two cases were eumycete. The sensitivity of vancocin was the highest,followed by li- carcillin sodium-potassium clavulanate,imipenem-cilastatin sodium and levofloxaein; the sensitivity of zinacef, azithromycin and piperacillin was lowest. Conclusion The main pathogenic bacterium of VAP are Gram-negative bacteria and staphylococcus aureus with high drug resistance. The choice of suitable antibiotics according to the result of drug sensitivity test is the key to the treatment of VAP.