重症监护室呼吸机相关性肺炎患者80例病原菌分析

The analysis of pathogenic bacteria and its prevention of ICU patients with ventilator associated pneumonia in 80 cases

目的：对重症监护室（ICU）呼吸机相关性肺炎（VAP）的抗菌治疗进行探讨，同时分析 VAP 的防治策略。方法对入住 ICU 的80例 VAP 患者的临床指标和微生物资料进行统计分析。结果VAP 的致病菌是鲍曼不动杆菌和铜绿假单胞菌为主的革兰阴性菌，共分离出病原菌200株，其中革兰阴性菌占76．0％，鲍曼不动杆菌菌株数量最多，还有肺炎克雷伯菌、铜绿假单胞菌等等。革兰阳性菌占24．0％，其中金黄色葡萄球菌占10．5％，此外还有表皮葡萄球菌、溶血葡萄球菌等等。真菌类比例为11．0％。根据微生物检验结果给予相应抗菌治疗后，VAP 感染参数（包括：体温、白细胞计数和菌株数）逐渐于10 d 左右恢复正常。结论VAP 致病菌主要为革兰阴性菌，且两种以上的致病菌多重感染的情况较多，治疗时应充分分析患者相关微生物学数据和临床监测数据后，制定个性化的抗菌治疗方案。

Objective To explore the treatment of the ICU ventilator associated pneumonia（VAP）,and the prevention strategy.Methods Analyzed the clinical features and microbiological data of 80 ICU VAP patients. Results The main pathogenic bacterias of VAP were acinetobacter baumannii and pseudomonas aeruginosa,which were Gram negative bacteria.A total of 200 strains pathogenic bacteria were isolated,in which,Gram negative bacteria reached to 76.0%,which mainly including：acinetobacter baumannii strains,klebsiella pneumoniae,pseudomonas aeruginosa and so on.24.0% was Gram positive bacteria,including staphylococcus aureus accounted for 10.5%,and the epidermis staphylococcus,hemolysis staphylococcus and so on.Proportion of fungi was 11.0%.According to the results of microbiological data,the effective anti-microbial treatments were administered.After treatments for 10 days, the VAP infection parameters（including temperature,the white blood cell count and the number of strains）were grad-ually back to normal.Conclusion The main VAP pathogenic bacteria are Gram negative bacteria,patients commonly＆amp;nbsp;are infected by two or more bacterias,which lead to the multiple infection,the treatment should be fully based on mi-crobiology and clinical monitoring data,and the formulating personalization antibacterial treatment.