我院老年患者呼吸机相关性肺炎病原菌分布及药敏分析

Analysis of distribution and drug sensitivity of pathogens in elder patients with ventilator-associated pneumonia

目的研究我院老年住院患者呼吸机相关肺炎(VAP)的病原菌分布及其药物敏感性,对临床用药进行指导。方法对我院收治的100例确诊为呼吸机相关性肺炎患者的临床资料进行分析。结果 100例VAP患者共分离224株菌株,病原菌以革兰氏阴性菌为主,共153株(68.3%),革兰氏阳性54株(24.1%),真菌17株(7.6%)。革兰氏阴性菌中以铜绿假单胞菌(24.18%)、鲍曼不动杆菌(18.95%)、肺炎克雷伯杆菌(17.65%)、大肠埃希菌(11.76%)为主;革兰氏阳性菌中以金黄色葡萄球菌(62.96%)为主;真菌以白色念珠菌最多(64.7%)。病原菌普遍耐药,革兰阴性菌对亚胺培南、多粘菌素B较敏感,革兰阳性菌对万古霉素、替考拉宁敏感。结论我院老年患者呼吸机相关性肺炎病原菌以革兰阴性菌为主,病原菌耐药性普遍严重。

Objective To study the distribution and drug sensitivity of pathogens in elder patients with ventilator-associated pneumonia（VAP） in order to guide the clinical use of antibiotics.Methods The clinical data of 100 VAP patients were retrospectively analyzed.Results A total of 224 strains was isolated,which included 68.3% of Gram-negative（G-） bacteria,24.1% of Gram-positive（G＋） bacteria and 7.6% of fungi.The G-bacteria included Pseudomonas aeruginosa（24.18%）,Acinetobacter baumannii（18.95%）,Klebsiella pneumonia（17.65%）,and Escherichia coli（11.76%）.The G＋ bacteria mainly consisted of Staphylococcus aureus（62.96%）.Fungi was mostly made up of Candida albicans（64.7%）.The pathogen strains were commonly resistant to the antibiotics while G＋ bacteria were sensitive to imipenem and polymyxin B and G-bacteria were sensitive to vancomycin and teicoplanin.Conclusion G-bacteria are the most common bacteria in elderly VAP patients and the strains show a general resistance to the common drugs.