神经科重症监护病房医院获得性肺炎病原菌分析

Analysis of pathogen causing hospital acquired pneumonia in neuro-intensive care unit

目的了解神经科重症监护病房(N-ICU)医院获得性肺炎(HAP)病原菌的分布特点,为临床合理选用抗菌药物提供依据。方法收集2010年9月～2012年2月医院N-ICU符合HAP的患者65例,对痰培养分离的病原菌进行药敏结果分析。结果 65例HAP患者,痰培养分离的病原菌以革兰阴性杆菌为主(84.0%),其次为革兰阳性球菌(13.2%)和真菌(2.8%);革兰阴性杆菌中前3位依次是鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯菌,对常规抗菌药物耐药率高;革兰阳性球菌对万古霉素、利奈唑烷和替加环素显示高度敏感性。结论该院N-ICU的HAP主要病原菌为多重耐药革兰阴性杆菌,在临床抗感染治疗中,加强细菌耐药性监测,合理使用抗菌药物十分重要。

【Objective】 To understand distribution characteristics of pathogen causing hospital-acquired pneumonia（HAP） in the neuro-intensive care unit（N-ICU）,to provide the basis for rational use of clinical antibiotics.【Methods】 From the 65 cases of HAP patients of our hospital N-ICU in 2010 September to 2012 February,to analyze the results of drug sensitivity about the isolated pathogenic bacteria of sputum culture.【Results】 In 65 cases of HAP patients,the isolated pathogenic bacteria of sputum culture to gram-negative bacilli（84%）,followed by the gram-positive cocci（13.2%） and fungi（2.8%）.The first 3 followed by Bauman acinetobacter,Pseudomonas aeruginosa and Klebsiella pneumoniae in gram-negative bacilli,resistance rate to conventional antimicrobial drug is high.The gram-positive cocci show high sensitivity to vancomycin,linezolid and tigecycline.【Conclusion】 Main pathogenic bacteria is multiple drug resistant gram negative bacilli for HAP in our hospital N-ICU,to strengthen the surveillance of bacterial resistance and the rational use of antimicrobial agents is very important in the clinical resistance to infection treatment.