呼吸机相关性肺炎新生儿气管导管末端病原学分析

Tracheal Catheter Tip of Neonatal Ventilator-associated Pneumonia: A Pathogenic Analysis

目的分析新生儿呼吸机相关性肺炎(VAP)的病原学特点和药物敏感性,为新生儿VAP的临床治疗提供依据。方法选择2009年12月—2012年6月在我院新生儿病房行呼吸机机械通气治疗并确诊为VAP的59例新生儿为研究对象,对气管导管末端的细菌培养结果和药敏试验结果进行回顾性分析。结果 59例新生儿共送检标本62份,55份导管末端细菌培养阳性,阳性率为88.7%。其中革兰阴性杆菌48份(87.3%),革兰阳性菌5份(9.1%),白色念珠菌2份(3.2%),培养阴性7份(11.3%)。55种菌株均有不同程度的药物敏感率及耐药性,革兰阴性杆菌对药物有较好的敏感性,革兰阳性球菌对药物有较大的耐药性。结论新生儿VAP的主要致病菌是以革兰阴性杆菌为主,革兰阳性菌较少见。

Objective To investigate the etiologic features of neonatal ventilator - associated pneumonia （VAP） and its drug sensitivity, to provide a basis for neonatal VAP treatment. Methods A retrospective investigation was done to analyze pathogenic features and drug sensitivity in 59 VAP neonates undergoing treatment of mechanical ventilation from Dec. 2009 to June 2012. Results Totally 62 specimens were sent for check, bacterial culture of 55 cases was positive （88.7%）, including 48 cases of Gram -negative bacilli （87. 3% ）, 5 Gram - positive bacilli （9. 1% ）, 2 canclida albicans （3.2%）, 7 negative cuhures （ 11.3% ）. Fifty - five strains had different degrees of drug sensitivity and drug resistance, Gram - negative bacilli had good drug sensitivity, while Gram - positive had big drug resistance. Conclusion Gram - negative bacilli are the main patho- gens of neonatal VAP, Gram - positive bacilli is less common.