外科监护病房中呼吸机相关性肺炎病原学分析

Risk factors and etiology analysis of ventilator-associated pneumonia in surgical intensive care unit

目的:分析外科ICU中呼吸机相关性肺炎(VAP)的病原学特点。方法:回顾2011年1月至2012年12月,入SICU治疗的应用机械通气>48h的非心脏手术患者117例,分为VAP组(26例)和非VAP组(91例),通过采用两组患者的临床生物学资料,总结VAP组患者的病学特点。结果:两组在确诊VAP前使用抗生素的种类、是否存在非感染性肺疾患、是否存在肺外感染灶,差异有统计学意义(P<0.05)。VAP的主要致病菌为鲍曼氏不动杆菌、醋酸钙-鲍曼复合不动杆菌等革兰氏阴性菌,其次为真菌和革兰氏阳性菌。结论:VAP的主要病原菌为革兰阴性菌,且存在严重的耐药现象。

Objective： To analysis etiological characteristics of ventilatorassociated pneumonia （VAP） in surgical intensive care unit. Methods： Retrospective study of 117 non cardiac operation patients with me chanical ventilation over 48 hours between Jan. 2011 and Dec. 2012 in our department and the patients were separated as VAP group and nonVAP group. Look back on the clinical document and microbiological examina tion results, summarize the etiological characteristics of VAP group. Results： There is significant statistical difference between the two groups （ P 〈 0. 05 ） in type of antibiotics used before diagnosed VAP, the existence of noninfectious disease, extrapulmonary infection sites. In Surgical intensive care unit, the major pathogenic bacterium is Acinetobacter baumannii and Acinetobacter calcoaceticusbaumannii complex, etc. Conclusion： The major pathogenic bacterium is Gramnegative bacilli, and with severe antibiotic resistance.