新生儿呼吸机相关性肺炎病原菌分析

Analysis of neonatal ventilator-associated pneumonia pathogens

目的:探讨新生儿呼吸机相关性肺炎(ventilator-associatedpneumonia,VAP)的病原菌分布、变迁以及对抗生素的敏感性变化。方法:回顾性分析我科2011年1月1日至2012年12月31日80例VAP患儿的气管导管培养病原学结果及药敏试验,按年份分为两组,对比病原菌分布及耐药性的变迁。结果:80例患儿分离出94株病原菌,革兰阳性菌占44.6%,革兰阴性菌占55.3%。2011年以革兰阳性菌为主,2012年以革兰阴性菌为主,且出现超广谱耐药菌株。结论:新生儿免疫力低下,机械通气易导致病原菌种植引起感染。多重耐药菌日渐增多,临床应合理使用抗生素,改善环境、流程及人员配置,严格灭菌消毒制度。

Objective： To investigate the distribution, changes and sensitivity to antibiotics of pathogens of neonatal-ventilator associated pneumonia（VAP）. Methods： 65 cases of endotracheal tube culture etiology results and sensitivity test of VAP patients in our department from January 1, 2011 to Semptember 31, 2012 were retrospectivly analyzed;the cases were divided in to two groups： 2011 groupand 2012 group;their pathogen distribution and resistance were compared. Results： 94 pathogens were isolated from 65 patients. gram-positive bacteria accounted for44.6%, while gram-negative bacteria accounted for 55.3%. The majority in 2011 was gram-positive bacteria, while in2012 was gram-negative bacteria, and multidrug-resistance pathogens were found in 2012. Conclusions： Due to immature immunity, the mechanical ventilation can cause infection in neonates. The multidrug-resistance pathogens were increased, but the choices of antibiotics were few. We should use antibiotics reasonably and improve the configuration of wards and stuffs, and carry out the sterilization system strictly.